Healthcare Provider Details

I. General information

NPI: 1811909419
Provider Name (Legal Business Name): MVP HEALTH, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/12/2006
Last Update Date: 06/17/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12350 SW 132ND CT SUITE 212
MIAMI FL
33186-6456
US

IV. Provider business mailing address

12350 SW 132ND CT SUITE 212
MIAMI FL
33186-6456
US

V. Phone/Fax

Practice location:
  • Phone: 305-235-2666
  • Fax: 305-235-7080
Mailing address:
  • Phone: 305-235-2666
  • Fax: 305-235-7080

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number299992195
License Number StateFL

VIII. Authorized Official

Name: MR. REY GOMEZ
Title or Position: PRESIDENT
Credential:
Phone: 305-235-2666