Healthcare Provider Details

I. General information

NPI: 1730403916
Provider Name (Legal Business Name): VICTORIAN NURSING SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/17/2010
Last Update Date: 03/17/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

530 S FEDERAL HWY SUITE 101
DEERFIELD BEACH FL
33441-4140
US

IV. Provider business mailing address

530 S FEDERAL HWY SUITE 101
DEERFIELD BEACH FL
33441-4140
US

V. Phone/Fax

Practice location:
  • Phone: 954-571-0461
  • Fax: 954-571-0464
Mailing address:
  • Phone: 954-571-0461
  • Fax: 954-571-0464

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number30211027
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number30211027
License Number StateFL

VIII. Authorized Official

Name: MR. RON MATTHEWS
Title or Position: CHIEF FINANCIAL OFFICER
Credential:
Phone: 305-821-1262