Provider Demographics
NPI:1174297717
Name:HEALTH FIRST MEDICAL GROUP LLC
Entity Type:Organization
Organization Name:HEALTH FIRST MEDICAL GROUP LLC
Other - Org Name:THE ORTHOPEDIC CENTER
Other - Org Type:Other Name
Authorized Official - Title/Position:VP PROFESSIONAL FEE SERVICES
Authorized Official - Prefix:
Authorized Official - First Name:LORA
Authorized Official - Middle Name:
Authorized Official - Last Name:MORSE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:321-434-6116
Mailing Address - Street 1:3300 S FISKE BLVD
Mailing Address - Street 2:CREDENTIALING
Mailing Address - City:ROCKLEDGE
Mailing Address - State:FL
Mailing Address - Zip Code:32955-4306
Mailing Address - Country:US
Mailing Address - Phone:321-434-5055
Mailing Address - Fax:
Practice Address - Street 1:1421 MALABAR RD NE STE 200
Practice Address - Street 2:
Practice Address - City:PALM BAY
Practice Address - State:FL
Practice Address - Zip Code:32907-2559
Practice Address - Country:US
Practice Address - Phone:321-308-2660
Practice Address - Fax:321-984-9303
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-06
Last Update Date:2022-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL008009000Medicaid