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General NPI Number Information
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NPI Number | 1447249149
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Entity Type | Organization
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Legal Business Name | VICTORIA NURSING & REHABILITATION CENTER, INC
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Dates
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Enumeration Date | 10/17/2005
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Last Update Date | 09/04/2024
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Provider Practice Location Address
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Address Line | 955 NW 3RD ST
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City | MIAMI
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State | FL
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Zip | 33128-1274
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Country | US
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Telephone | 305-548-4020
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Fax | 305-777-2000
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Provider Business Mailing Address
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Address Line | 955 NW 3RD ST
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City | MIAMI
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State | FL
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Zip | 33128-1274
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Country | US
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Telephone | 305-548-4020
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Fax | 305-548-5018
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | RICHARD STACEY
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Credential |
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Telephone | 305-548-4020
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number | SNF130471016
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License Number State | FL
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