1538300181 NPI number — NUVIEW TELEHEALTH, LLC

Table of content: (NPI 1538300181)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1538300181 NPI number — NUVIEW TELEHEALTH, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
NUVIEW TELEHEALTH, LLC
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:
6
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:
1538300181
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/08/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 743129
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ATLANTA
Provider Business Mailing Address State Name:
GA
Provider Business Mailing Address Postal Code:
30384-3067
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
561-299-3667
Provider Business Mailing Address Fax Number:
561-299-3670

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1825 NW CORPORATE BLVD STE 105
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BOCA RATON
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33431-8554
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
561-299-3667
Provider Business Practice Location Address Fax Number:
561-299-3670
Provider Enumeration Date:
03/11/2009

Additional Information

Authorized Official

Authorized Official Last Name:
LUDWIG
Authorized Official First Name:
BRYAN
Authorized Official Middle Name:
M
Authorized Official Title or Position:
EVP
Authorized Official Telephone Number:
561-299-3667

Provider Taxonomy Codes

  • Taxonomy code: 207R00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207RC0200X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207RN0300X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207RP1001X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2084N0400X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 174400000X , with the licence number: L07000110286 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 500107957 , issued by the state of ( MO ) . This identifiers is of the category "MEDICAID".
  • Identifier: Q054067 , issued by the state of ( TN ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1538300181 , issued by the state of ( WV ) . This identifiers is of the category "MEDICAID".
  • Identifier: 002140700 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 003389095 , issued by the state of ( MS ) . This identifiers is of the category "MEDICAID".
  • Identifier: 002140700 . This is a "Florida Medicaid Provider ID" identifier , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".




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