Healthcare Provider Details

I. General information

NPI: 1124898937
Provider Name (Legal Business Name): GERIATRIC CARE AND VITALS CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/03/2024
Last Update Date: 01/03/2024
Certification Date: 01/03/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6053 WARREN AVE
NEW PORT RICHEY FL
34653-4641
US

IV. Provider business mailing address

6053 WARREN AVE
NEW PORT RICHEY FL
34653-4641
US

V. Phone/Fax

Practice location:
  • Phone: 646-763-5764
  • Fax:
Mailing address:
  • Phone: 646-763-5764
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246RP1900X
TaxonomyPhlebotomy Technician
License Number
License Number State

VIII. Authorized Official

Name: XHOZEF PJETRI
Title or Position: PHLEBOTOMIST
Credential: CPT
Phone: 646-763-5764