Healthcare Provider Details

I. General information

NPI: 1881690360
Provider Name (Legal Business Name): VISITING INHOME PHYSICIANS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/21/2005
Last Update Date: 08/21/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5913 S CONGRESS AVE
ATLANTIS FL
33462-1303
US

IV. Provider business mailing address

5913 S CONGRESS AVE
ATLANTIS FL
33462-1303
US

V. Phone/Fax

Practice location:
  • Phone: 561-966-8842
  • Fax: 561-966-8832
Mailing address:
  • Phone: 561-966-8842
  • Fax: 561-966-8832

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License NumberCH9091
License Number StateFL

VIII. Authorized Official

Name: MR. DAVID GREYDINGER
Title or Position: PRESIDENT
Credential: DC
Phone: 561-966-8842