Provider Demographics
NPI:1518283894
Name:VACATION HEROES LLC
Entity Type:Organization
Organization Name:VACATION HEROES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:ALAN
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:740-974-9680
Mailing Address - Street 1:2001 BISCAYNE BLVD APT 3601
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33137-5028
Mailing Address - Country:US
Mailing Address - Phone:740-974-9680
Mailing Address - Fax:
Practice Address - Street 1:2001 BISCAYNE BLVD APT 3601
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33137-5028
Practice Address - Country:US
Practice Address - Phone:740-974-9680
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-12
Last Update Date:2010-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care