Healthcare Provider Details

I. General information

NPI: 1407020225
Provider Name (Legal Business Name): VISITING NURSE ASSOCIATION MOBILE CLINIC INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/14/2008
Last Update Date: 11/08/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2400 SE MONTEREY RD SUITE 300
STUART FL
34996-3351
US

IV. Provider business mailing address

2400 SE MONTEREY RD SUITE 300
STUART FL
34996-3351
US

V. Phone/Fax

Practice location:
  • Phone: 772-286-1844
  • Fax: 772-286-0738
Mailing address:
  • Phone: 772-286-1844
  • Fax: 772-286-0738

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. DONALD R CROW
Title or Position: PRESIDENT
Credential:
Phone: 772-286-1844