Provider Demographics
NPI:1538206941
Name:VISITING NURSE MANAGED CARE CORPORATION
Entity type:Organization
Organization Name:VISITING NURSE MANAGED CARE CORPORATION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JORGE
Authorized Official - Middle Name:ALBERTO
Authorized Official - Last Name:PEREDA
Authorized Official - Suffix:
Authorized Official - Credentials:MBA
Authorized Official - Phone:305-477-3189
Mailing Address - Street 1:7719 NW 48TH ST
Mailing Address - Street 2:SUITE 330
Mailing Address - City:DORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33166-5456
Mailing Address - Country:US
Mailing Address - Phone:305-477-3189
Mailing Address - Fax:305-477-5436
Practice Address - Street 1:7719 NW 48TH ST
Practice Address - Street 2:SUITE 330
Practice Address - City:DORAL
Practice Address - State:FL
Practice Address - Zip Code:33166-5456
Practice Address - Country:US
Practice Address - Phone:305-477-3189
Practice Address - Fax:305-477-5436
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-01
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL02-251B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL02-=========OtherTHIRD PARTY ADMINISTRATOR