Provider Demographics
NPI:1225289697
Name:DOLCE VIDA HOME HEALTH LLC
Entity Type:Organization
Organization Name:DOLCE VIDA HOME HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:VICTOR
Authorized Official - Middle Name:HUGO
Authorized Official - Last Name:GONZALEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:956-793-8388
Mailing Address - Street 1:PO BOX 4830
Mailing Address - Street 2:
Mailing Address - City:EDINBURG
Mailing Address - State:TX
Mailing Address - Zip Code:78540-4830
Mailing Address - Country:US
Mailing Address - Phone:956-793-8388
Mailing Address - Fax:956-424-3898
Practice Address - Street 1:1309 E RIDGE RD
Practice Address - Street 2:SUITE 2B
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78503-1517
Practice Address - Country:US
Practice Address - Phone:956-630-1231
Practice Address - Fax:956-424-3898
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-03
Last Update Date:2015-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health