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General NPI Number Information
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NPI Number | 1811392962
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Entity Type | Organization
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Legal Business Name | VICINITAS
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Dates
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Enumeration Date | 10/31/2014
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Last Update Date | 10/31/2014
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Provider Practice Location Address
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Address Line | 1200 N FEDERAL HWY STE 200
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City | BOCA RATON
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State | FL
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Zip | 33432-2813
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Country | US
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Telephone | 561-961-8190
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Fax |
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Provider Business Mailing Address
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Address Line | 1200 N FEDERAL HWY STE 200
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City | BOCA RATON
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State | FL
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Zip | 33432-2813
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Country | US
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Telephone | 561-961-8190
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Fax |
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Authorized Official
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Title or Position | CFO
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Name | ROBERT PREATO
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Credential |
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Telephone | 561-961-8190
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 40961
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License Number State | GA
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