MEDICARE: VICTORY HEALTHCARE CORPORATION

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	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1598451924
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VICTORY HEALTHCARE CORPORATION

Provider Business Mailing Address
First Line	:	2450 SW 137TH AVE STE 208
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33175-6312
Country	:	US
Telephone Number	:	305-394-6004
Fax Number	:	305-394-6005

Provider Business Practice Location Address
First Line	:	2450 SW 137TH AVE STE 208
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33175-6312
Country	:	US
Telephone Number	:	305-394-6004
Fax Number	:	305-394-6005

Authorized Official
Title or Position	:	ADMINISTRATOR, OWNER
Name	:	VICTORIA CANALES
Credential	:	RN
Telephone Number	:	305-394-6004

Provider Enumeration Date	:	04/18/2023
Last Update Date	:	02/09/2026

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Directions to “VICTORY HEALTHCARE CORPORATION ” Practice Location

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