Provider Demographics
NPI:1477367522
Name:HERITAGE UNIVERSAL OF SOUTH FLORIDA INC
Entity type:Organization
Organization Name:HERITAGE UNIVERSAL OF SOUTH FLORIDA INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:
Authorized Official - Last Name:VALDES
Authorized Official - Suffix:
Authorized Official - Credentials:PMHNP
Authorized Official - Phone:561-633-9037
Mailing Address - Street 1:1031 IVES DAIRY RD STE 228
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33179-2538
Mailing Address - Country:US
Mailing Address - Phone:561-633-9037
Mailing Address - Fax:
Practice Address - Street 1:1031 IVES DAIRY RD STE 228
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33179-2538
Practice Address - Country:US
Practice Address - Phone:561-633-9037
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-02-06
Last Update Date:2025-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)