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General NPI Number Information
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NPI Number | 1073923876
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Entity Type | Organization
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Legal Business Name | HEALTHFAIR PLUS DE PA
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Dates
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Enumeration Date | 05/01/2014
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Last Update Date | 01/15/2016
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Provider Practice Location Address
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Address Line | 1000 N WEST ST SUITE 1200
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City | WILMINGTON
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State | DE
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Zip | 19801-1050
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Country | US
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Telephone | 407-672-0919
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Fax |
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Provider Business Mailing Address
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Address Line | 1030 SPRING VILLAS PT STE 3000
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City | WINTER SPRINGS
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State | FL
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Zip | 32708-6621
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Country | US
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Telephone | 407-672-0919
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Fax |
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Authorized Official
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Title or Position | CHIEF ADMINISTRATIVE OFFICER
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Name | RAY EKBATANI
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Credential |
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Telephone | 407-672-0919
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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