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General NPI Number Information
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NPI Number | 1184715682
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Entity Type | Organization
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Legal Business Name | VIRGIN HEALTH CORPORATION
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Dates
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Enumeration Date | 09/28/2006
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Last Update Date | 11/01/2024
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Provider Practice Location Address
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Address Line | 5735 NW 84TH AVE # 101
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City | DORAL
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State | FL
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Zip | 33166-3310
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Country | US
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Telephone | 305-818-1710
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Fax | 833-630-9883
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Provider Business Mailing Address
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Address Line | 5735 NW 84TH AVE STE 101
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City | DORAL
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State | FL
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Zip | 33166-3310
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Country | US
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Telephone | 305-818-1710
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Fax | 833-630-9883
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Authorized Official
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Title or Position | CEO
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Name | MR. FERNANDO V DE LA CRUZ JR.
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Credential |
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Telephone | 305-818-1710
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 299992258
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License Number State | FL
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