Provider Demographics
NPI:1871015701
Name:VEREDY S.A.S LLC
Entity Type:Organization
Organization Name:VEREDY S.A.S LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SA-C
Authorized Official - Prefix:MR
Authorized Official - First Name:EDINSON
Authorized Official - Middle Name:ANTONIO
Authorized Official - Last Name:MATOS
Authorized Official - Suffix:
Authorized Official - Credentials:SA-C
Authorized Official - Phone:954-801-8559
Mailing Address - Street 1:705 SW 148TH AVE APT 202
Mailing Address - Street 2:
Mailing Address - City:DAVIE
Mailing Address - State:FL
Mailing Address - Zip Code:33325-3081
Mailing Address - Country:US
Mailing Address - Phone:954-801-8559
Mailing Address - Fax:
Practice Address - Street 1:705 SW 148 AV APT 202
Practice Address - Street 2:
Practice Address - City:DAVIE
Practice Address - State:FL
Practice Address - Zip Code:33325
Practice Address - Country:US
Practice Address - Phone:954-801-8559
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-07-12
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL246ZC0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical AssistantGroup - Single Specialty