Provider Demographics
NPI:1164421236
Name:VISITING NURSES ASSOCIATION OF SOUTHWEST FL, INC
Entity Type:Organization
Organization Name:VISITING NURSES ASSOCIATION OF SOUTHWEST FL, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:ANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:VANN
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:239-337-4848
Mailing Address - Street 1:3653 CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33901-8218
Mailing Address - Country:US
Mailing Address - Phone:239-337-4848
Mailing Address - Fax:239-337-2132
Practice Address - Street 1:3653 CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33901-8218
Practice Address - Country:US
Practice Address - Phone:239-337-4848
Practice Address - Fax:239-337-2132
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-20
Last Update Date:2008-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLHHA21277096251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLX8047Medicare ID - Type UnspecifiedFLU SHOT BILLING PART B