Healthcare Provider Details

I. General information

NPI: 1104433267
Provider Name (Legal Business Name): HEALTH FIRST MEDICAL GROUP LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/23/2020
Last Update Date: 09/07/2023
Certification Date: 09/07/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

930 S HARBOR CITY BLVD STE 101
MELBOURNE FL
32901-1901
US

IV. Provider business mailing address

3300 S FISKE BLVD MANAGED CARE
ROCKLEDGE FL
32955
US

V. Phone/Fax

Practice location:
  • Phone: 321-345-7570
  • Fax: 321-586-5408
Mailing address:
  • Phone: 321-434-5112
  • Fax: 321-434-5485

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: LORA MORSE
Title or Position: VP PROFESSIONAL FEE SERVICES
Credential:
Phone: 321-434-6106