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General NPI Number Information
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NPI Number | 1497008973
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Entity Type | Organization
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Legal Business Name | ENHANCED HEALTH LLC
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Dates
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Enumeration Date | 10/20/2012
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Last Update Date | 10/20/2012
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Provider Practice Location Address
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Address Line | 3537 FOREST HILL BLVD
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City | WEST PALM BEACH
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State | FL
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Zip | 33406-5867
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Country | US
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Telephone | 407-761-9661
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Fax | 888-724-3705
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Provider Business Mailing Address
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Address Line | 13506 SUMMERPORT VILLAGE PKWY SUITE 256
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City | WINDERMERE
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State | FL
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Zip | 34786-7366
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Country | US
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Telephone | 407-761-9661
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Fax | 888-724-3705
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. VIDOR FRIEDMAN
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Credential | MD
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Telephone | 407-761-9661
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | ME72697
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License Number State | FL
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