MEDICARE: UNIVITA OF FLORIDA, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332B00000X	Durable Medical Equipment & Medical Supplies	193	FL

General Provider Information

NPI Number	:	1093714495
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	UNIVITA OF FLORIDA, INC.

Provider Business Mailing Address
First Line	:	15800 SW 25TH ST
Second Line	:
City	:	MIRAMAR
State	:	FL
Zip	:	33027-4222
Country	:	US
Telephone Number	:	954-333-1000
Fax Number	:

Provider Business Practice Location Address
First Line	:	3700 COMMERCE PKWY
Second Line	:
City	:	MIRAMAR
State	:	FL
Zip	:	33025-3912
Country	:	US
Telephone Number	:	954-333-1000
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	MR. MICHAEL A MUCHNICKI
Credential	:
Telephone Number	:	954-333-1000

Provider Enumeration Date	:	07/18/2005
Last Update Date	:	06/19/2015

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