Healthcare Provider Details

I. General information

NPI: 1386799443
Provider Name (Legal Business Name): VITAS HEALTHCARE CORPORATION OF FLORIDA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/25/2007
Last Update Date: 12/19/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2201 LUCIEN WAY SUITE 100
MAITLAND FL
32751-7003
US

IV. Provider business mailing address

3046 CORPORATE WAY
MIRAMAR FL
33025-6547
US

V. Phone/Fax

Practice location:
  • Phone: 407-875-0028
  • Fax: 407-691-4574
Mailing address:
  • Phone: 305-350-6756
  • Fax: 305-350-6993

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number5014096161
License Number StateFL

VIII. Authorized Official

Name: NICHOLAS WESTFALL
Title or Position: CEO
Credential:
Phone: 305-374-4143