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General NPI Number Information
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NPI Number | 1639797087
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Entity Type | Organization
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Legal Business Name | VITAL SENIOR CARE INC
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Dates
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Enumeration Date | 07/13/2020
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Last Update Date | 07/27/2020
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Provider Practice Location Address
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Address Line | 2700 W CYPRESS CREEK RD STE B104
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City | FT LAUDERDALE
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State | FL
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Zip | 33309-1718
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Country | US
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Telephone | 954-647-7608
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Fax |
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Provider Business Mailing Address
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Address Line | 2700 W CYPRESS CREEK RD STE B104
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City | FT LAUDERDALE
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State | FL
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Zip | 33309-1718
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Country | US
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Telephone | 954-647-7608
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MICHELLE BARRERA
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Credential |
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Telephone | 754-220-6494
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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