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General NPI Number Information
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NPI Number | 1336731660
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Entity Type | Organization
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Legal Business Name | VANGUARD HEALTH CENTER
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Dates
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Enumeration Date | 02/08/2021
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Last Update Date | 01/14/2022
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Provider Practice Location Address
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Address Line | 8241 SW 124TH ST
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City | PINECREST
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State | FL
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Zip | 33156-5900
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Country | US
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Telephone | 786-254-5834
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Fax |
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Provider Business Mailing Address
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Address Line | 14109 S DIXIE HWY
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City | PALMETTO BAY
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State | FL
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Zip | 33176-7223
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | RAUL PUIG
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Credential |
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Telephone | 786-254-5834
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number |
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License Number State |
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