Individual ProviderHenry Madison HaireInternal MedicineAllopathic & Osteopathic PhysiciansPractice Address670 Glades Rd, 400-A, Boca Raton, FL 33431-6461(561) 955-5365(561) 955-2570PECOS EnrollmentBased on the most recent information from CMS, provider Henry Madison Haire does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 3 days ago.Profile DetailsProvider ID1285799593Provider TypeIndividualFull NameHaire, Henry MadisonCredentialMDGenderMaleSole ProprietorNoEnumeration Date12/27/2006Last Updated6/18/2016Contact InformationPractice LocationPractice Address670 Glades Rd, 400-A, Boca Raton, FL 33431-6461Phone(561) 955-5365Fax(561) 955-3577Mailing LocationMailing Address670 Glades Rd, 400-A, Boca Raton, FL 33431-6461Phone(561) 955-2570Fax(561) 955-2572Provider TaxonomiesCodeDescriptionLicenseCode207R00000XPrimaryDescriptionInternal MedicineAllopathic & Osteopathic PhysiciansLicenseMD-15019HawaiiCode207RN0300XDescriptionInternal MedicineAllopathic & Osteopathic PhysiciansLicenseME 28988FloridaProvider IdentifiersIDDescriptionIssuerID064928700DescriptionMedicaidIssuerUnlistedFlorida