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General NPI Number Information
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NPI Number | 1609789445
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Entity Type | Organization
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Legal Business Name | HEALTH 100 LLC
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Dates
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Enumeration Date | 09/23/2026
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Last Update Date | 09/24/2026
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Provider Practice Location Address
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Address Line | 1321 WAGNER AVE
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City | LEHIGH ACRES
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State | FL
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Zip | 33972-8720
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Country | US
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Telephone | 512-842-0359
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Fax |
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Provider Business Mailing Address
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Address Line | 1913 S MINTLE ST TRLR 42
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City | AIRWAY HEIGHTS
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State | WA
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Zip | 99001-5262
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MGR
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Name | ANGEL OQUENDO PEREZ
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Credential |
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Telephone | 512-842-0359
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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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 | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number |
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License Number State |
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