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NPI Code Detail

MEDICARE: GREAT HEALTH MEDICAL FL PA

MEDICARE: GREAT HEALTH MEDICAL FL PA
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
1207Q00000XFamily Medicine Physician

General Provider Information

NPI Number : 1093589442
Entity Type Code : Organization
Provider Name (Legal Business Name) : GREAT HEALTH MEDICAL FL PA
Provider Business Mailing Address
First Line : 407 WILLOUGHBY AVE
Second Line :
City : BROOKLYN
State : NY
Zip : 11205-4590
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 5300 W 16TH AVE
Second Line :
City : HIALEAH
State : FL
Zip : 33012-2104
Country : US
Telephone Number : 212-201-1252
Fax Number :
Authorized Official
Title or Position : OWNER
Name : AHRON FELDMAN
Credential :
Telephone Number : 212-734-6621
Provider Enumeration Date : 11/07/2023
Last Update Date : 02/20/2025

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Directions to “GREAT HEALTH MEDICAL FL PA ” Practice Location

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