Healthcare Provider Details

I. General information

NPI: 1831940451
Provider Name (Legal Business Name): UNITED STATES AND LATIN VETERANS SUPPORT EMBASSY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/01/2024
Last Update Date: 04/01/2024
Certification Date: 04/01/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1035 SW 12TH CT
MIAMI FL
33135-5415
US

IV. Provider business mailing address

1035 SW 12TH CT
MIAMI FL
33135-5415
US

V. Phone/Fax

Practice location:
  • Phone: 239-440-9846
  • Fax:
Mailing address:
  • Phone: 239-440-9846
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code176P00000X
TaxonomyFuneral Director
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251K00000X
TaxonomyPublic Health or Welfare Agency
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code251V00000X
TaxonomyVoluntary or Charitable Agency
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code261QC1500X
TaxonomyCommunity Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MS. LUIZA INEZ ORTIZ
Title or Position: SEVP
Credential:
Phone: 239-440-9846