Provider Demographics
NPI:1801478565
Name:THE VITA PLUG LLC
Entity type:Organization
Organization Name:THE VITA PLUG LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DON
Authorized Official - Prefix:
Authorized Official - First Name:ANDREA
Authorized Official - Middle Name:
Authorized Official - Last Name:ALORRO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-232-9102
Mailing Address - Street 1:1451 W CYPRESS CREEK RD STE 385
Mailing Address - Street 2:
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33309-1961
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1451 W CYPRESS CREEK RD STE 385
Practice Address - Street 2:
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33309-1961
Practice Address - Country:US
Practice Address - Phone:786-205-4764
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-22
Last Update Date:2021-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health