Healthcare Provider Details

I. General information

NPI: 1336790419
Provider Name (Legal Business Name): VANKAT MEDICAL ASSIST, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/20/2019
Last Update Date: 09/20/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2424 N FEDERAL HWY APT 107
BOYNTON BEACH FL
33435-2430
US

IV. Provider business mailing address

2424 N FEDERAL HWY APT 107
BOYNTON BEACH FL
33435-2430
US

V. Phone/Fax

Practice location:
  • Phone: 888-322-6432
  • Fax: 888-329-6432
Mailing address:
  • Phone: 888-322-6432
  • Fax: 888-329-6432

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WR0006X
TaxonomyRegistered Nurse First Assistant
License Number
License Number State

VIII. Authorized Official

Name: NADINE V GOELZ
Title or Position: OWNER
Credential: RNFA
Phone: 888-322-6432