Healthcare Provider Details
I. General information
NPI: 1881372225
Provider Name (Legal Business Name): VITAS HEALTHCARE CORPORATION ATLANTIC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/06/2023
Last Update Date: 07/06/2023
Certification Date: 07/06/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
70 S ORANGE AVE STE 210
LIVINGSTON NJ
07039-4903
US
IV. Provider business mailing address
3046 CORPORATE WAY
MIRAMAR FL
33025-6547
US
V. Phone/Fax
- Phone: 973-994-4738
- Fax: 973-422-5385
- Phone: 305-374-4143
- Fax: 305-350-6993
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207QH0002X |
| Taxonomy | Hospice and Palliative Medicine (Family Medicine) Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363L00000X |
| Taxonomy | Nurse Practitioner |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207RH0002X |
| Taxonomy | Hospice and Palliative Medicine (Internal Medicine) Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
NICHOLAS
WESTFALL
Title or Position: PRESIDENT & CEO
Credential:
Phone: 513-618-2240