Healthcare Provider Details

I. General information

NPI: 1063523132
Provider Name (Legal Business Name): VITAS HEALTHCARE CORPORATION ATLANTIC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/31/2006
Last Update Date: 04/30/2021
Certification Date: 04/30/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3251 OLD LEE HWY STE 200
FAIRFAX VA
22030-1504
US

IV. Provider business mailing address

3046 CORPORATE WAY
MIRAMAR FL
33025-6547
US

V. Phone/Fax

Practice location:
  • Phone: 703-270-4300
  • Fax: 703-270-4350
Mailing address:
  • Phone: 305-374-4143
  • Fax: 305-350-6993

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License NumberHSP12125
License Number StateVA

VIII. Authorized Official

Name: NICHOLAS WESTFALL
Title or Position: CEO
Credential:
Phone: 305-373-4141