Healthcare Provider Details

I. General information

NPI: 1689578866
Provider Name (Legal Business Name): CURE VAVEZ LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/02/2026
Last Update Date: 10/02/2026
Certification Date: 10/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9478 BLACK HAWK CT
MANASSAS PARK VA
20111-3011
US

IV. Provider business mailing address

9478 BLACK HAWK CT
MANASSAS PARK VA
20111-3011
US

V. Phone/Fax

Practice location:
  • Phone: 201-479-1498
  • Fax: 201-479-1498
Mailing address:
  • Phone: 201-479-1498
  • Fax: 201-479-1498

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number StateNULL

VIII. Authorized Official

Name: DARICK SHOUKAT
Title or Position: OWNER
Credential:
Phone: 201-479-1498