Provider Demographics
NPI:1972874477
Name:FENIX HEALTH CARE ,INC
Entity Type:Organization
Organization Name:FENIX HEALTH CARE ,INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:SAHILY
Authorized Official - Middle Name:
Authorized Official - Last Name:YABOR
Authorized Official - Suffix:
Authorized Official - Credentials:NBCTMB LMT
Authorized Official - Phone:786-663-2269
Mailing Address - Street 1:3390 SW 15TH ST
Mailing Address - Street 2:
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33312-3635
Mailing Address - Country:US
Mailing Address - Phone:786-663-2269
Mailing Address - Fax:
Practice Address - Street 1:3390 SW 15TH ST
Practice Address - Street 2:
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33312-3635
Practice Address - Country:US
Practice Address - Phone:786-663-2269
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-16
Last Update Date:2012-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation