Provider Demographics
NPI:1891337689
Name:DE VARONA MEDICAL SERVICES, CORP
Entity Type:Organization
Organization Name:DE VARONA MEDICAL SERVICES, CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:TANIA
Authorized Official - Middle Name:
Authorized Official - Last Name:ADANDEVARONA
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:786-226-5768
Mailing Address - Street 1:5880 SW 13TH ST
Mailing Address - Street 2:
Mailing Address - City:WEST MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33144-5704
Mailing Address - Country:US
Mailing Address - Phone:786-226-5768
Mailing Address - Fax:
Practice Address - Street 1:1281 NW 6TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33125-4719
Practice Address - Country:US
Practice Address - Phone:305-326-6766
Practice Address - Fax:833-246-2041
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-13
Last Update Date:2020-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WG0000XNursing Service ProvidersRegistered NurseGeneral PracticeGroup - Single Specialty