1104829696 NPI number — VISITING NURSE ASSOCIATION OF FLORIDA INC

Table of content: (NPI 1104829696)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1104829696 NPI number — VISITING NURSE ASSOCIATION OF FLORIDA INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
VISITING NURSE ASSOCIATION OF FLORIDA INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1104829696
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/17/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2400 SE MONTEREY RD
Provider Second Line Business Mailing Address:
STE 300
Provider Business Mailing Address City Name:
STUART
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
34996-3351
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
772-286-1844
Provider Business Mailing Address Fax Number:
772-286-0738

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2400 SE MONTEREY RD
Provider Second Line Business Practice Location Address:
STE 300
Provider Business Practice Location Address City Name:
STUART
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
34996-3351
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
772-286-1844
Provider Business Practice Location Address Fax Number:
772-286-0738
Provider Enumeration Date:
05/27/2005

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
SKEES
Authorized Official First Name:
TARA
Authorized Official Middle Name:
V
Authorized Official Title or Position:
COMPLAINCE
Authorized Official Telephone Number:
772-419-5524

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X , with the licence number:  21258096 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 251E00000X , with the licence number: 21254095 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 251E00000X , with the licence number: 21984096 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 251E00000X , with the licence number: 299991370 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 251E00000X , with the licence number: 299991442 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 251E00000X , with the licence number: 299991644 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 008774500 . This is a "HOME & COMMUNITY BASED SERVICES WAIVER" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 008774500 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 008774500 . This is a "HOME COMMUNITY BASED SERVICE WAIVER" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".