Healthcare Provider Details

I. General information

NPI: 1265671333
Provider Name (Legal Business Name): HEALTH FIRST PHYSICIAN SPECIALTIES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/13/2009
Last Update Date: 02/25/2025
Certification Date: 02/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1350 HICKORY ST TRAUMA PROVIDERS
MELBOURNE FL
32901-3224
US

IV. Provider business mailing address

PO BOX 561530
ROCKLEDGE FL
32956-1530
US

V. Phone/Fax

Practice location:
  • Phone: 321-434-1401
  • Fax: 321-434-1667
Mailing address:
  • Phone: 321-434-4674
  • Fax: 321-434-4642

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

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