Organization Active NPI

Vip Home Clinic, LLC

  • Family Medicine Physician
  • Fort Lauderdale, FL
National Provider Identifier
1114657848
Registry record updated Jun 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
VIP HOME CLINIC, LLC
Practice address
757 SE 17TH St Ste 1229
Fort Lauderdale, FL 33316-2960
Phone
(954) 507-6347
NPI assigned
Jun 15, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 15, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Miss Delone Garcia
Title
Manager
Phone
(954) 383-0181

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

757 SE 17TH St Ste 1229
Fort Lauderdale, FL 33316-2960

Mailing address

757 SE 17TH St Ste 1229
Fort Lauderdale, FL 33316-2960
Phone (954) 507-6347

Other names 1

  • Vip home clinic, Llc Former legal business name

National Provider Directory

National Provider Directory

Locations

757 SE 17th Street Cswy
Ft Lauderdale, FL 33316
Phone (917) 979-3743

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1655251200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1655251200000",
    "number": "1114657848",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "757 SE 17TH ST STE 1229",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333162960",
            "telephone_number": "954-507-6347"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "757 SE 17TH ST STE 1229",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333162960",
            "telephone_number": "954-507-6347"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VIP HOME CLINIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-06-15",
        "last_updated": "2022-06-15",
        "certification_date": "2022-06-03",
        "status": "A",
        "authorized_official_last_name": "GARCIA",
        "authorized_official_first_name": "DELONE",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "954-383-0181",
        "authorized_official_name_prefix": "Miss"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Vip home clinic, Llc",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Fort Lauderdale, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.