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General NPI Number Information
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NPI Number | 1144525650
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Entity Type | Organization
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Legal Business Name | VETERAN NURSING AGENCY LLC
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Dates
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Enumeration Date | 01/13/2011
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Last Update Date | 12/23/2013
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Provider Practice Location Address
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Address Line | 12230 FOREST HILL BLVD STE. 208
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City | WELLINGTON
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State | FL
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Zip | 33414-5700
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Country | US
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Telephone | 561-227-1549
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Fax |
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Provider Business Mailing Address
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Address Line | 12230 FOREST HILL BLVD STE. 208
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City | WELLINGTON
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State | FL
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Zip | 33414-5700
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Country | US
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Telephone | 561-227-1549
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Fax |
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | DR. TIFFANY N. MCCALLA
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Credential | MD
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Telephone | 954-592-4961
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | D00063078
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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