Provider Demographics
NPI:1134560675
Name:FASTRAK ONE MEDICAL, INC.
Entity type:Organization
Organization Name:FASTRAK ONE MEDICAL, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:
Authorized Official - Last Name:FANTO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-275-9051
Mailing Address - Street 1:2101 VISTA PKWY
Mailing Address - Street 2:SUITE 4034
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33411-2706
Mailing Address - Country:US
Mailing Address - Phone:561-275-9051
Mailing Address - Fax:561-828-5954
Practice Address - Street 1:2101 VISTA PKWY
Practice Address - Street 2:SUITE 4034
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33411-2706
Practice Address - Country:US
Practice Address - Phone:561-275-9051
Practice Address - Fax:561-828-5954
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-12
Last Update Date:2013-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies