MEDICARE: VIRGO HEALTH CARE

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	251B00000X	Case Management Agency
2	253Z00000X	In Home Supportive Care Agency
3	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1578010831
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VIRGO HEALTH CARE

Provider Business Mailing Address
First Line	:	1774 15TH AVE N
Second Line	:
City	:	LAKE WORTH
State	:	FL
Zip	:	33460-1734
Country	:	US
Telephone Number	:	321-362-6622
Fax Number	:

Provider Business Practice Location Address
First Line	:	1774 15TH AVE N
Second Line	:
City	:	LAKE WORTH
State	:	FL
Zip	:	33460-1734
Country	:	US
Telephone Number	:	321-362-6622
Fax Number	:

Authorized Official
Title or Position	:	ADMIN
Name	:	PROSPER JOSEPH
Credential	:	M.D.
Telephone Number	:	321-362-6622

Provider Enumeration Date	:	09/04/2016
Last Update Date	:	09/04/2016

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Directions to “VIRGO HEALTH CARE ” Practice Location

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