Healthcare Provider Details

I. General information

NPI: 1558015404
Provider Name (Legal Business Name): HEALTH FIRST MEDICAL GROUP, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/09/2022
Last Update Date: 02/09/2022
Certification Date: 02/09/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3830 S HIGHWAY A1A STE C5
MELBOURNE BEACH FL
32951-3145
US

IV. Provider business mailing address

3300 S FISKE BLVD
ROCKLEDGE FL
32955-4306
US

V. Phone/Fax

Practice location:
  • Phone: 321-345-7579
  • Fax:
Mailing address:
  • Phone: 321-434-5055
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207XX0004X
TaxonomyOrthopaedic Foot and Ankle Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: LORA MORSE
Title or Position: VP PROFESSIONAL SERVICES
Credential:
Phone: 321-434-6116