MEDICARE: FLORIDA EM-I MEDICAL SERVICES, 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
1	363A00000X	Physician Assistant
2	363L00000X	Nurse Practitioner

General Provider Information

NPI Number	:	1316764988
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FLORIDA EM-I MEDICAL SERVICES, PA

Provider Business Mailing Address
First Line	:	PO BOX 80170
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19101-1170
Country	:	US
Telephone Number	:	954-939-5000
Fax Number	:	877-250-6889

Provider Business Practice Location Address
First Line	:	1600 S ANDREWS AVE
Second Line	:
City	:	FT LAUDERDALE
State	:	FL
Zip	:	33316-2510
Country	:	US
Telephone Number	:	954-939-5000
Fax Number	:	877-250-6889

Authorized Official
Title or Position	:	AUTHORIZED OFFICIAL
Name	:	CHRISTOPHER KENNEDY
Credential	:
Telephone Number	:	207-807-9009

Provider Enumeration Date	:	09/24/2024
Last Update Date	:	12/01/2025

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