MEDICARE: FAMILY VISITATION & SERVICES, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)

General Provider Information

NPI Number	:	1609730456
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FAMILY VISITATION & SERVICES, LLC

Provider Business Mailing Address
First Line	:	11011 SHERIDAN ST STE 314
Second Line	:
City	:	HOLLYWOOD
State	:	FL
Zip	:	33026-1532
Country	:	US
Telephone Number	:	305-209-9788
Fax Number	:

Provider Business Practice Location Address
First Line	:	11011 SHERIDAN ST STE 314
Second Line	:
City	:	HOLLYWOOD
State	:	FL
Zip	:	33026-1532
Country	:	US
Telephone Number	:	305-209-9788
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	VIRGINIA GADDIS
Credential	:
Telephone Number	:	305-209-9788

Provider Enumeration Date	:	12/15/2025
Last Update Date	:	12/15/2025

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