Provider Demographics
NPI:1245870112
Name:VISITING PHYSICIANS OF SOUTH FLORIDA
Entity type:Organization
Organization Name:VISITING PHYSICIANS OF SOUTH FLORIDA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MBR
Authorized Official - Prefix:
Authorized Official - First Name:TONI-LYNN
Authorized Official - Middle Name:
Authorized Official - Last Name:WALKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:941-777-0101
Mailing Address - Street 1:1600 MEADOWBROOK ST
Mailing Address - Street 2:
Mailing Address - City:LAKE PLACID
Mailing Address - State:FL
Mailing Address - Zip Code:33852-5727
Mailing Address - Country:US
Mailing Address - Phone:989-941-9975
Mailing Address - Fax:
Practice Address - Street 1:1301 10TH ST E STE B
Practice Address - Street 2:
Practice Address - City:PALMETTO
Practice Address - State:FL
Practice Address - Zip Code:34221-4161
Practice Address - Country:US
Practice Address - Phone:941-777-0101
Practice Address - Fax:989-777-5803
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-08
Last Update Date:2020-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontologyGroup - Single Specialty