Organization
FENIX RISING MEDICAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOMO EBANKS (PRESIDENT)
(561) 713-1433
Entity
Organization
Contact information
Practice address
8401 LAKE WORTH RD STE 110, LAKE WORTH, FL 33467-2400
(561) 713-1433
Mailing address
8401 LAKE WORTH RD STE 110, LAKE WORTH, FL 33467-2400
(561) 713-1433
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
04/08/2020
Last updated
03/16/2021
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