MEDICARE: HEALTH 1 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	207Q00000X	Family Medicine Physician

General Provider Information

NPI Number	:	1609954718
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HEALTH 1 INC

Provider Business Mailing Address
First Line	:	4121 NW 5TH ST
Second Line	:	SUITE 215
City	:	PLANTATION
State	:	FL
Zip	:	33317-2120
Country	:	US
Telephone Number	:	954-358-0301
Fax Number	:

Provider Business Practice Location Address
First Line	:	4121 NW 5TH ST
Second Line	:	SUITE 215
City	:	PLANTATION
State	:	FL
Zip	:	33317-2120
Country	:	US
Telephone Number	:	954-358-0301
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	PATRICK FENELUS
Credential	:	DC
Telephone Number	:	954-358-0301

Provider Enumeration Date	:	11/02/2006
Last Update Date	:	08/22/2020

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Directions to “HEALTH 1 INC ” Practice Location

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