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General NPI Number Information
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NPI Number | 1477367522
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Entity Type | Organization
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Legal Business Name | HERITAGE UNIVERSAL OF SOUTH FLORIDA INC
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Dates
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Enumeration Date | 02/06/2025
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Last Update Date | 02/06/2025
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Provider Practice Location Address
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Address Line | 1031 IVES DAIRY RD STE 228
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City | MIAMI
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State | FL
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Zip | 33179-2538
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Country | US
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Telephone | 561-633-9037
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Fax |
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Provider Business Mailing Address
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Address Line | 1031 IVES DAIRY RD STE 228
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City | MIAMI
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State | FL
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Zip | 33179-2538
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Country | US
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Telephone | 561-633-9037
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JULIE VALDES
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Credential | PMHNP
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Telephone | 561-633-9037
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251300000X
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Taxonomy Name | Local Education Agency (LEA)
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License Number |
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License Number State |
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