MEDICARE: VISITING INHOME PHYSICIANS INC

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	208D00000X	General Practice Physician	CH9091	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	CH9091	OTHER	FL	LICENSE NUMBER

General Provider Information

NPI Number	:	1881690360
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VISITING INHOME PHYSICIANS INC

Provider Business Mailing Address
First Line	:	5913 S CONGRESS AVE
Second Line	:
City	:	ATLANTIS
State	:	FL
Zip	:	33462-1303
Country	:	US
Telephone Number	:	561-966-8842
Fax Number	:	561-966-8832

Provider Business Practice Location Address
First Line	:	5913 S CONGRESS AVE
Second Line	:
City	:	ATLANTIS
State	:	FL
Zip	:	33462-1303
Country	:	US
Telephone Number	:	561-966-8842
Fax Number	:	561-966-8832

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. DAVID GREYDINGER
Credential	:	DC
Telephone Number	:	561-966-8842

Provider Enumeration Date	:	06/21/2005
Last Update Date	:	08/21/2012

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