Provider Demographics
NPI:1912684994
Name:VIBRANT LIFE HOME HEALTH CARE LLC
Entity Type:Organization
Organization Name:VIBRANT LIFE HOME HEALTH CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP
Authorized Official - Prefix:MRS
Authorized Official - First Name:YERAINE
Authorized Official - Middle Name:
Authorized Official - Last Name:IZQUIERDO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-417-8085
Mailing Address - Street 1:1543 NE 123RD ST
Mailing Address - Street 2:
Mailing Address - City:NORTH MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33161-6029
Mailing Address - Country:US
Mailing Address - Phone:305-417-8085
Mailing Address - Fax:786-829-6087
Practice Address - Street 1:1539 NE 123RD ST
Practice Address - Street 2:
Practice Address - City:NORTH MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33161-6029
Practice Address - Country:US
Practice Address - Phone:305-417-8085
Practice Address - Fax:786-829-6087
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-30
Last Update Date:2023-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care