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General NPI Number Information
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NPI Number | 1801730171
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Entity Type | Organization
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Legal Business Name | VICK'S MEDICAL, LLC
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Dates
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Enumeration Date | 04/16/2026
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Last Update Date | 04/16/2026
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Provider Practice Location Address
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Address Line | 2906 N 35TH TER
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City | HOLLYWOOD
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State | FL
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Zip | 33021-8406
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Country | US
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Telephone | 954-612-6857
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Fax |
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Provider Business Mailing Address
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Address Line | 2906 N 35TH TER
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City | HOLLYWOOD
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State | FL
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Zip | 33021-8406
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Country | US
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Telephone | 954-612-6857
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | SAMANTHA VICK
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Credential | APRN
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Telephone | 954-612-6857
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State | NULL
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