Provider Demographics
NPI:1013575505
Name:AVIVA NURSING SERVICES INC.
Entity Type:Organization
Organization Name:AVIVA NURSING SERVICES INC.
Other - Org Name:MIND AND MOBILITY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MATEO
Authorized Official - Middle Name:
Authorized Official - Last Name:MARTINEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-993-6299
Mailing Address - Street 1:2655 E OAKLAND PARK BLVD
Mailing Address - Street 2:SUITE 5
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33306
Mailing Address - Country:US
Mailing Address - Phone:786-237-8420
Mailing Address - Fax:786-431-4061
Practice Address - Street 1:7900 OAK LANE
Practice Address - Street 2:SUITE 400
Practice Address - City:MIAMI LAKES
Practice Address - State:FL
Practice Address - Zip Code:33016
Practice Address - Country:US
Practice Address - Phone:305-889-7041
Practice Address - Fax:786-431-4061
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-30
Last Update Date:2022-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL102011800Medicaid