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NPI Code Detail

MEDICARE: VISITING INHOME PHYSICIAN INC

MEDICARE: VISITING INHOME PHYSICIAN 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
1207QG0300XGeriatric Medicine (Family Medicine) Physician

General Provider Information

NPI Number : 1790903128
Entity Type Code : Organization
Provider Name (Legal Business Name) : VISITING INHOME PHYSICIAN INC
Provider Business Mailing Address
First Line : 5913 S CONGRESS AVE
Second Line :
City : ATLANTIS
State : FL
Zip : 33462-1303
Country : US
Telephone Number : 561-296-5243
Fax Number : 561-721-9581
Provider Business Practice Location Address
First Line : 5913 S CONGRESS AVE
Second Line :
City : ATLANTIS
State : FL
Zip : 33462-1303
Country : US
Telephone Number : 561-296-5243
Fax Number : 561-721-9581
Authorized Official
Title or Position : OWNER
Name : MR. DAVID GREYDINGER
Credential : DC
Telephone Number : 561-296-5243
Provider Enumeration Date : 04/23/2007
Last Update Date : 03/27/2012

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Directions to “VISITING INHOME PHYSICIAN INC ” Practice Location

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