Healthcare Provider Details

I. General information

NPI: 1831926781
Provider Name (Legal Business Name): HEALTH SYSTEMS OF FLORIDA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/16/2024
Last Update Date: 09/16/2024
Certification Date: 09/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

422 STONEMONT DR
WESTON FL
33326-3500
US

IV. Provider business mailing address

3541 US HIGHWAY 441 S STE 304
OKEECHOBEE FL
34974-6247
US

V. Phone/Fax

Practice location:
  • Phone: 813-992-8803
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: BRIAN FAY
Title or Position: OWNER
Credential:
Phone: 813-992-8803