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General NPI Number Information
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NPI Number | 1538620299
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Entity Type | Organization
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Legal Business Name | VP VERSATILE CONSULTANTS LLC
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Dates
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Enumeration Date | 03/26/2019
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Last Update Date | 03/26/2019
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Provider Practice Location Address
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Address Line | 3738 COCOPLUM CIR
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City | COCONUT CREEK
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State | FL
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Zip | 33063-5984
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Country | US
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Telephone | 954-670-6728
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 16094
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City | PLANTATION
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State | FL
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Zip | 33318-6094
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Country | US
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Telephone | 954-670-6728
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | PAUL MARTINEZ
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Credential |
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Telephone | 954-670-6728
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 335E00000X
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Taxonomy Name | Prosthetic/Orthotic Supplier
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License Number |
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License Number State |
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