Healthcare Provider Details

I. General information

NPI: 1831738392
Provider Name (Legal Business Name): HEALTH FIRST MEDICAL GROUP, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/02/2020
Last Update Date: 06/04/2025
Certification Date: 06/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1350 HICKORY ST # 101
MELBOURNE FL
32901-3224
US

IV. Provider business mailing address

PO BOX 749156
ATLANTA GA
30374-9156
US

V. Phone/Fax

Practice location:
  • Phone: 321-434-1401
  • Fax:
Mailing address:
  • Phone: 321-434-5055
  • Fax:

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: SHAUN RONAN
Title or Position: VP REVENUE OPERATIONS
Credential:
Phone: 321-434-5482