Victorian Manor, Inc.

Primary specialty

Intellectual and/or Developmental Disabilities Residential Treatment FacilityTaxonomy code 320600000X

Legal business name

VICTORIAN MANOR, INC.

Practice address

11150 SW 42ND CT
Davie, FL 33328-2140

Phone

(954) 236-4300

NPI assigned

Jul 14, 2020

Organization subpart

No

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

Authorized official

Name

Noemi Rodriguez

Title

Onwner

Phone

(954) 236-4300

Specialties & licenses 1

Addresses

Other names 1

• Victorian Manor, Inc. Former legal business name

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

{
    "created_epoch": "1594684800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1594684800000",
    "number": "1972121192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15140 SW 38TH ST",
            "city": "DAVIE",
            "state": "FL",
            "postal_code": "333312755",
            "telephone_number": "954-816-3203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11150 SW 42ND CT",
            "city": "DAVIE",
            "state": "FL",
            "postal_code": "333282140",
            "telephone_number": "954-236-4300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VICTORIAN MANOR, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-07-14",
        "last_updated": "2020-07-14",
        "certification_date": "2020-07-14",
        "status": "A",
        "authorized_official_last_name": "RODRIGUEZ",
        "authorized_official_first_name": "NOEMI",
        "authorized_official_title_or_position": "ONWNER",
        "authorized_official_telephone_number": "954-236-4300"
    },
    "taxonomies": [
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Victorian Manor, Inc.",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Ashley Victor, M.S.
• Natalie Victor
• Yoamna Rosario Victores
• Victoria Villa, Inc
• Jaileen Victoria
• Isabelo Ian Domingo Victorio, ARNP
• Victorious Health LLC
• Concepcion Vidal
• Rita Ellen Vidur, LMT
• Ashlee Vieux

• Intellectual and/or Developmental Disabilities Residential Treatment Facility in Davie, FL
• Providers in Davie, FL by specialty
• Intellectual and/or Developmental Disabilities Residential Treatment Facility in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 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.