Healthcare Provider Details

I. General information

NPI: 1689882334
Provider Name (Legal Business Name): VIP AMERICA, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/18/2007
Last Update Date: 10/16/2024
Certification Date: 10/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2500 S KANNER HWY STE 3
STUART FL
34994-4600
US

IV. Provider business mailing address

2500 S KANNER HWY STE 3
STUART FL
34994-4600
US

V. Phone/Fax

Practice location:
  • Phone: 772-220-6005
  • Fax: 772-220-5867
Mailing address:
  • Phone: 772-220-6005
  • Fax: 772-220-5867

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3747A0650X
TaxonomyAttendant Care Provider
License Number
License Number State

VIII. Authorized Official

Name: ASHLEY SKIPPER
Title or Position: VP OF OPERATIONS
Credential:
Phone: 772-220-6005