MEDICARE: VIVA HOME HEALTH CARE 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	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1972855682
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VIVA HOME HEALTH CARE INC

Provider Business Mailing Address
First Line	:	1543 LAKELAND HILLS BLVD
Second Line	:	STE: 8
City	:	LAKELAND
State	:	FL
Zip	:	33805-3246
Country	:	US
Telephone Number	:	800-261-8482
Fax Number	:	866-775-8482

Provider Business Practice Location Address
First Line	:	1543 LAKELAND HILLS BLVD
Second Line	:	STE: 8
City	:	LAKELAND
State	:	FL
Zip	:	33805-3246
Country	:	US
Telephone Number	:	800-261-8482
Fax Number	:	866-775-8482

Authorized Official
Title or Position	:	CEO/ADMINISTRATOR
Name	:	DR. JAYANT PATEL
Credential	:	MD
Telephone Number	:	813-930-8482

Provider Enumeration Date	:	10/04/2012
Last Update Date	:	10/04/2012

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