MEDICARE: FORTICI MEDICI HEALTH 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	332B00000X	Durable Medical Equipment & Medical Supplies

General Provider Information

NPI Number	:	1659248136
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FORTICI MEDICI HEALTH LLC

Provider Business Mailing Address
First Line	:	4261 NE 18TH AVE
Second Line	:
City	:	POMPANO BEACH
State	:	FL
Zip	:	33064-5914
Country	:	US
Telephone Number	:	561-572-5110
Fax Number	:

Provider Business Practice Location Address
First Line	:	4261 NE 18TH AVE
Second Line	:
City	:	POMPANO BEACH
State	:	FL
Zip	:	33064-5914
Country	:	US
Telephone Number	:	561-572-5110
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	ROMONICA JASMINE FIELDS
Credential	:
Telephone Number	:	561-707-1556

Provider Enumeration Date	:	10/20/2025
Last Update Date	:	04/15/2026

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