MEDICARE: FALL SOLUTIONS INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	ME0038105	FL
2	207Q00000X	Family Medicine Physician	OS7932	FL

General Provider Information

NPI Number	:	1033282322
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FALL SOLUTIONS INC

Provider Business Mailing Address
First Line	:	2100 E HALLANDALE BEACH BLVD STE 301
Second Line	:
City	:	HALLANDALE BEACH
State	:	FL
Zip	:	33009-3771
Country	:	US
Telephone Number	:	954-455-2132
Fax Number	:

Provider Business Practice Location Address
First Line	:	2100 E HALLANDALE BEACH BLVD STE 301
Second Line	:
City	:	HALLANDALE BEACH
State	:	FL
Zip	:	33009-3771
Country	:	US
Telephone Number	:	954-455-2132
Fax Number	:

Authorized Official
Title or Position	:	COO
Name	:	MR. JEREMY WAXMAN
Credential	:
Telephone Number	:	954-455-2132

Provider Enumeration Date	:	11/16/2006
Last Update Date	:	09/27/2007

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Directions to “FALL SOLUTIONS INC ” Practice Location

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