Provider Demographics
NPI:1689371247
Name:STAT IV 2 U
Entity Type:Organization
Organization Name:STAT IV 2 U
Other - Org Name:STAT IV 2 U
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER/MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:LENNY
Authorized Official - Middle Name:
Authorized Official - Last Name:MARANZANO
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:321-236-1070
Mailing Address - Street 1:2927 ADDISON DR
Mailing Address - Street 2:
Mailing Address - City:MELBOURNE
Mailing Address - State:FL
Mailing Address - Zip Code:32940-7633
Mailing Address - Country:US
Mailing Address - Phone:321-236-1070
Mailing Address - Fax:
Practice Address - Street 1:2927 ADDISON DR
Practice Address - Street 2:
Practice Address - City:MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32940-7633
Practice Address - Country:US
Practice Address - Phone:321-236-1070
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-14
Last Update Date:2023-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251F00000XAgenciesHome Infusion
No251J00000XAgenciesNursing Care
No253Z00000XAgenciesIn Home Supportive Care
No261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
No347C00000XTransportation ServicesPrivate Vehicle