MEDICARE: FENIXX IN FLOW

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	202D00000X	Integrative Medicine Physician

General Provider Information

NPI Number	:	1871456756
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FENIXX IN FLOW

Provider Business Mailing Address
First Line	:	4210 COLUMBIA RD STE 4A
Second Line	:
City	:	MARTINEZ
State	:	GA
Zip	:	30907-0403
Country	:	US
Telephone Number	:	706-666-6984
Fax Number	:

Provider Business Practice Location Address
First Line	:	4210 COLUMBIA RD STE 4A
Second Line	:
City	:	MARTINEZ
State	:	GA
Zip	:	30907-0403
Country	:	US
Telephone Number	:	706-666-6984
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	JESSICA SIMONE GARCIA
Credential	:
Telephone Number	:	706-306-3775

Provider Enumeration Date	:	12/08/2025
Last Update Date	:	12/08/2025

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