Healthcare Provider Details
I. General information
NPI: 1265194237
Provider Name (Legal Business Name): FLORENA VAKI
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 10/07/2021
Last Update Date: 10/07/2021
Certification Date: 10/07/2021
Deactivation Date:
Reactivation Date:
III. Provider practice location address
134 N 300 E
AMERICAN FORK UT
84003-1745
US
IV. Provider business mailing address
134 N 300 E
AMERICAN FORK UT
84003-1745
US
V. Phone/Fax
- Phone: 424-240-4735
- Fax:
- Phone: 424-240-4735
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 3747A0650X |
| Taxonomy | Attendant Care Provider |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: