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General NPI Number Information
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NPI Number | 1912684994
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Entity Type | Organization
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Legal Business Name | VIBRANT LIFE HOME HEALTH CARE LLC
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Dates
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Enumeration Date | 06/30/2023
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Last Update Date | 08/10/2023
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Provider Practice Location Address
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Address Line | 1539 NE 123RD ST
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City | NORTH MIAMI
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State | FL
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Zip | 33161-6029
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Country | US
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Telephone | 305-417-8085
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Fax | 786-829-6087
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Provider Business Mailing Address
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Address Line | 1543 NE 123RD ST
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City | NORTH MIAMI
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State | FL
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Zip | 33161-6029
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Country | US
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Telephone | 305-417-8085
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Fax | 786-829-6087
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Authorized Official
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Title or Position | VP
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Name | MRS. YERAINE IZQUIERDO
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Credential |
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Telephone | 305-417-8085
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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