Provider Demographics
NPI:1295029379
Name:V&G PERSONAL HEALTH CARE GROUP, INC
Entity Type:Organization
Organization Name:V&G PERSONAL HEALTH CARE GROUP, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:VICTOR
Authorized Official - Middle Name:
Authorized Official - Last Name:CABEZUDO
Authorized Official - Suffix:
Authorized Official - Credentials:ARNP
Authorized Official - Phone:561-635-8855
Mailing Address - Street 1:PO BOX 540233
Mailing Address - Street 2:
Mailing Address - City:LAKE WORTH
Mailing Address - State:FL
Mailing Address - Zip Code:33454-0233
Mailing Address - Country:US
Mailing Address - Phone:561-635-8855
Mailing Address - Fax:
Practice Address - Street 1:19065 FLY ROD RUN
Practice Address - Street 2:
Practice Address - City:LOXAHATCHEE
Practice Address - State:FL
Practice Address - Zip Code:33470-6024
Practice Address - Country:US
Practice Address - Phone:561-635-8855
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-06
Last Update Date:2020-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Single Specialty