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General NPI Number Information
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NPI Number | 1275756090
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Entity Type | Organization
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Legal Business Name | VIP CARE PAVILION LTD.
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Dates
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Enumeration Date | 04/10/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 6810 S.W. 7TH STREET
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City | MARGATE
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State | FL
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Zip | 33068-0000
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Country | US
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Telephone | 954-971-2286
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Fax | 954-975-3523
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Provider Business Mailing Address
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Address Line | 6810 S.W. 7TH STREET
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City | MARGATE
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State | FL
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Zip | 33068-0000
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Country | US
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Telephone | 954-971-2286
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Fax | 954-975-3523
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MR. SCOTT ALAN COLTON
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Credential | R.N.
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Telephone | 954-971-2286
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 311500000X
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Taxonomy Name | Alzheimer Center (Dementia Center)
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License Number | AL4783
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License Number State | FL
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