MEDICARE: ENHANCED HEALTH LLC

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	207P00000X	Emergency Medicine Physician	ME72697	FL

General Provider Information

NPI Number	:	1497008973
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ENHANCED HEALTH LLC

Provider Business Mailing Address
First Line	:	13506 SUMMERPORT VILLAGE PKWY
Second Line	:	SUITE 256
City	:	WINDERMERE
State	:	FL
Zip	:	34786-7366
Country	:	US
Telephone Number	:	407-761-9661
Fax Number	:	888-724-3705

Provider Business Practice Location Address
First Line	:	3537 FOREST HILL BLVD
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33406-5867
Country	:	US
Telephone Number	:	407-761-9661
Fax Number	:	888-724-3705

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. VIDOR FRIEDMAN
Credential	:	MD
Telephone Number	:	407-761-9661

Provider Enumeration Date	:	10/20/2012
Last Update Date	:	10/20/2012

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Directions to “ENHANCED HEALTH LLC ” Practice Location

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