MEDICARE: HEALTH DRIVEN INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	343900000X	Non-emergency Medical Transport (VAN)

General Provider Information

NPI Number	:	1275188864
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HEALTH DRIVEN INC

Provider Business Mailing Address
First Line	:	1060 PETER RD
Second Line	:
City	:	DAYTONA BEACH
State	:	FL
Zip	:	32114-1732
Country	:	US
Telephone Number	:	321-745-5100
Fax Number	:

Provider Business Practice Location Address
First Line	:	1060 PETER RD
Second Line	:
City	:	DAYTONA BEACH
State	:	FL
Zip	:	32114-1732
Country	:	US
Telephone Number	:	321-745-5100
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	JALEEL WATSON
Credential	:
Telephone Number	:	321-745-5100

Provider Enumeration Date	:	08/09/2019
Last Update Date	:	08/09/2019

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Directions to “HEALTH DRIVEN INC ” Practice Location

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