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General NPI Number Information
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NPI Number | 1275440976
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Entity Type | Organization
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Legal Business Name | VIMAMB LLC
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Dates
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Enumeration Date | 08/26/2026
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Last Update Date | 08/26/2026
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Provider Practice Location Address
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Address Line | 5657 HAMPTON PARK CIR
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City | VERO BEACH
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State | FL
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Zip | 32966-2221
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Country | US
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Telephone | 786-687-2420
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Fax |
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Provider Business Mailing Address
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Address Line | 2843 FILLMORE ST APT 102
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City | HOLLYWOOD
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State | FL
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Zip | 33020-4252
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Country | US
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Telephone | 786-687-2420
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Fax |
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Authorized Official
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Title or Position | DIRECTOR OF BILLING
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Name | JEFF BRAZZLE
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Credential | CPC
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Telephone | 786-687-2420
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207XX0004X
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Taxonomy Name | Orthopaedic Foot and Ankle Surgery Physician
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License Number |
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License Number State |
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