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General NPI Number Information
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NPI Number | 1770939449
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Entity Type | Organization
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Legal Business Name | VERO BEACH FAMILY CARE INC.
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Dates
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Enumeration Date | 05/11/2016
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Last Update Date | 12/12/2016
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Provider Practice Location Address
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Address Line | 2651 20TH STREET
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City | VERO BEACH
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State | FL
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Zip | 32960-6602
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Country | US
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Telephone | 954-661-8151
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Fax |
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Provider Business Mailing Address
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Address Line | 3851 VIRGINIA AVE
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City | FORT PIERCE
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State | FL
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Zip | 34981-5515
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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 | VP
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Name | JERRY JACOBSON
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Credential |
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Telephone | 954-661-8151
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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