Healthcare Provider Details

I. General information

NPI: 1447915004
Provider Name (Legal Business Name): VA FOREIGN MEDICAL SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/08/2021
Last Update Date: 11/15/2021
Certification Date: 11/15/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CALLE EL MORROW, ESQ. PRESIDENTE VASQUEZE.#56
PUERTO PLATA DOMINICAN RTEPUBLIC
57021
DO

IV. Provider business mailing address

SDQ 647640 2250 N W 114TH AVE UNIT 1A
MIAMI FL
33192-0001
US

V. Phone/Fax

Practice location:
  • Phone: 809-320-7735
  • Fax: 980-216-6020
Mailing address:
  • Phone: 737-781-4120
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code302F00000X
TaxonomyExclusive Provider Organization
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code3336C0002X
TaxonomyClinic Pharmacy
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code2251H1300X
TaxonomyHuman Factors Physical Therapist
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code261QC1500X
TaxonomyCommunity Health Clinic/Center
License Number
License Number State
# 7
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. SCOTT JAMES MARTIN
Title or Position: CEO
Credential:
Phone: 809-320-7735