Medivan Health and Community Services, Inc.

Primary specialty

Voluntary or Charitable AgencyTaxonomy code 251V00000X

Legal business name

MEDIVAN HEALTH AND COMMUNITY SERVICES, INC.

Practice address

5101 NW 21St Ave
Suite 510
Fort Lauderdale, FL 33309-2792

Phone

(954) 735-9019

Fax

(954) 733-9315

NPI assigned

Sep 16, 2006

Organization subpart

No

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

Authorized official

Name

Ms. Sharon Ross, RN, DPA

Title

Executive Director

Phone

(954) 735-9019

Specialties & licenses 1

Addresses

Other names 1

• MediVan Project Other name

Locations

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

{
    "created_epoch": "1158364800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1730285883",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5101 NW 21ST AVE",
            "address_2": "SUITE 510",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333092792",
            "telephone_number": "954-735-9019",
            "fax_number": "954-733-9315"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5101 NW 21ST AVE",
            "address_2": "SUITE 510",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333092792",
            "telephone_number": "954-735-9019",
            "fax_number": "954-733-9315"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDIVAN HEALTH AND COMMUNITY SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-16",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ROSS",
        "authorized_official_first_name": "SHARON",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "954-735-9019",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "RN, DPA"
    },
    "taxonomies": [
        {
            "code": "251V00000X",
            "taxonomy_group": "",
            "desc": "Voluntary or Charitable",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MediVan Project",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Voluntary or Charitable Agency in Fort Lauderdale, FL
• Providers in Fort Lauderdale, FL by specialty
• Voluntary or Charitable Agency in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.