MEDICARE: HEALTH HOLDINGS COMPANY LLC

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	207R00000X	Internal Medicine Physician
2	261Q00000X	Clinic/Center

General Provider Information

NPI Number	:	1417520388
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HEALTH HOLDINGS COMPANY LLC

Provider Business Mailing Address
First Line	:	127 RIDGE CENTER DR
Second Line	:
City	:	DAVENPORT
State	:	FL
Zip	:	33837-6401
Country	:	US
Telephone Number	:	863-421-7400
Fax Number	:	863-421-7448

Provider Business Practice Location Address
First Line	:	127 RIDGE CENTER DR
Second Line	:
City	:	DAVENPORT
State	:	FL
Zip	:	33837-6401
Country	:	US
Telephone Number	:	863-421-7400
Fax Number	:	863-421-7448

Authorized Official
Title or Position	:	COO
Name	:	SANTIAGO MOISES MARTIN
Credential	:
Telephone Number	:	305-913-9441

Provider Enumeration Date	:	07/20/2021
Last Update Date	:	09/22/2021

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Directions to “HEALTH HOLDINGS COMPANY LLC ” Practice Location

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