Individual ProviderSamuel FoldyHospitalistAllopathic & Osteopathic PhysiciansPractice Address820 Prudential Dr Ste 304, Jacksonville, FL 32207-8205(904) 202-3860(904) 202-1032PECOS EnrollmentBased on the most recent information from CMS, provider Samuel Foldy is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.Part BMedicare Part BEnrolledHHAHome Health AgencyEnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records yesterday at 11:21 AM.Profile DetailsProvider ID1639630379Provider TypeIndividualFull NameFoldy, SamuelCredentialDOGenderMaleSole ProprietorNoEnumeration Date3/26/2019Last Updated8/8/2022Contact InformationPractice LocationPractice Address820 Prudential Dr Ste 304, Jacksonville, FL 32207-8205Phone(904) 202-3860Fax(904) 202-3846Mailing LocationMailing AddressPO Box 746638, Atlanta, GA 30374-6638Phone(904) 202-1032Fax(904) 376-4107Provider TaxonomiesCodeDescriptionLicenseCode208M00000XPrimaryDescriptionHospitalistAllopathic & Osteopathic PhysiciansLicenseOS18798FloridaCode207R00000XDescriptionInternal MedicineAllopathic & Osteopathic PhysiciansLicenseOS18798FloridaCode390200000XDescriptionStudent in an Organized Health Care Education/Training ProgramStudent, Health CareLicenseUO6496Florida