Provider Demographics
NPI:1811517691
Name:TUNNEL VISION SUPPORT SERVICES OF MIAMI, INC.
Entity type:Organization
Organization Name:TUNNEL VISION SUPPORT SERVICES OF MIAMI, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:PEBBLES
Authorized Official - Middle Name:
Authorized Official - Last Name:COLLINS-SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-218-4429
Mailing Address - Street 1:12214 SW 203RD TER
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33177-5260
Mailing Address - Country:US
Mailing Address - Phone:305-218-4429
Mailing Address - Fax:
Practice Address - Street 1:10711 SW 216TH ST STE 209
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33170-3139
Practice Address - Country:US
Practice Address - Phone:305-218-4429
Practice Address - Fax:786-250-5518
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-21
Last Update Date:2023-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251C00000XAgenciesDay Training, Developmentally Disabled Services