Provider Demographics
NPI:1336390020
Name:HEALTH FIRST PHYSICIAN SPECIALTIES INC
Entity Type:Organization
Organization Name:HEALTH FIRST PHYSICIAN SPECIALTIES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP PROFESSIONAL FEE REVENUE CYCLE
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:
Mailing Address - City:ROCKLEDGE
Mailing Address - State:FL
Mailing Address - Zip Code:32955-4306
Mailing Address - Country:US
Mailing Address - Phone:321-434-1981
Mailing Address - Fax:321-434-5485
Practice Address - Street 1:1350 S HICKORY ST
Practice Address - Street 2:SUITE 101D
Practice Address - City:MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32901-3224
Practice Address - Country:US
Practice Address - Phone:321-434-1401
Practice Address - Fax:321-434-1667
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HEALTH FIRST PHYSICIANS, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-10-01
Last Update Date:2023-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207XX0801XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic TraumaGroup - Multi-Specialty
No2086S0127XAllopathic & Osteopathic PhysiciansSurgeryTrauma SurgeryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL=========OtherTAX ID
FLAV714Medicare PIN