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General NPI Number Information
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NPI Number | 1285382689
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Entity Type | Organization
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Legal Business Name | VITALITY HOME HEALTH AGENCY OF FL, LLC.
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Dates
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Enumeration Date | 03/15/2022
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Last Update Date | 01/08/2024
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Provider Practice Location Address
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Address Line | 4000 HOLLYWOOD BLVD STE 555S
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City | HOLLYWOOD
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State | FL
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Zip | 33021-6853
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Country | US
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Telephone | 786-772-0201
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Fax | 786-772-0221
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Provider Business Mailing Address
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Address Line | 18975 COLLINS AVE UNIT 4202
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City | SUNNY ISLES BEACH
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State | FL
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Zip | 33160-5441
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Country | US
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Telephone | 917-968-4796
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | MISS GALINA BRAIMAN
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Credential |
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Telephone | 786-772-0201
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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 |
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License Number State |
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