Provider Demographics
NPI:1063037885
Name:MVIP HEALTHCARE
Entity Type:Organization
Organization Name:MVIP HEALTHCARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHAIRMAN/MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHELE
Authorized Official - Middle Name:
Authorized Official - Last Name:MORRISON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:954-438-0033
Mailing Address - Street 1:1601 N PALM AVE STE 101
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33026-3240
Mailing Address - Country:US
Mailing Address - Phone:954-661-8639
Mailing Address - Fax:
Practice Address - Street 1:1601 N PALM AVE STE 101
Practice Address - Street 2:
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33026-3240
Practice Address - Country:US
Practice Address - Phone:954-661-8639
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MORRISON VIP HEALTHCARE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-06-09
Last Update Date:2020-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty