Provider Demographics
NPI:1396978946
Name:VITALI HOME HEALTH CARE, COPORATION
Entity type:Organization
Organization Name:VITALI HOME HEALTH CARE, COPORATION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:TERESA
Authorized Official - Middle Name:
Authorized Official - Last Name:PEREZ
Authorized Official - Suffix:
Authorized Official - Credentials:LPN
Authorized Official - Phone:305-225-3390
Mailing Address - Street 1:175 FONTAINEBLEAU BLVD STE 2M2
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33172-7013
Mailing Address - Country:US
Mailing Address - Phone:305-225-3390
Mailing Address - Fax:305-225-3391
Practice Address - Street 1:175 FONTAINEBLEAU BLVD STE 2M2
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33172-7013
Practice Address - Country:US
Practice Address - Phone:305-225-3390
Practice Address - Fax:305-225-3391
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-31
Last Update Date:2009-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL299992250251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health