Provider Demographics
NPI:1427418623
Name:MEDIHEALTH, LLC
Entity Type:Organization
Organization Name:MEDIHEALTH, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRINCIPAL OWNER/CMO
Authorized Official - Prefix:
Authorized Official - First Name:JONATHAN
Authorized Official - Middle Name:S
Authorized Official - Last Name:WARE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:321-422-4866
Mailing Address - Street 1:2699 LEE RD
Mailing Address - Street 2:SUITE 315
Mailing Address - City:WINTER PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32789-1753
Mailing Address - Country:US
Mailing Address - Phone:321-422-4866
Mailing Address - Fax:866-280-0343
Practice Address - Street 1:2699 LEE RD
Practice Address - Street 2:SUITE 315
Practice Address - City:WINTER PARK
Practice Address - State:FL
Practice Address - Zip Code:32789-1753
Practice Address - Country:US
Practice Address - Phone:321-422-4866
Practice Address - Fax:866-280-0343
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-01
Last Update Date:2016-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty