Basic Information
| Provider Information | |||||||||
| NPI: | 1578820429 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | VMOREL HEALTH SERVICES LLC | ||||||||
| LastName: | |||||||||
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| OtherOrganizationName: | RENAISSANCE HEALTH SERVICES | ||||||||
| OtherOrganizationType: | 3 | ||||||||
| OtherLastName: | |||||||||
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| Mailing Information | |||||||||
| Address1: | 308 SOUTH HARBOR CITY BLVD | ||||||||
| Address2: | SUITE C | ||||||||
| City: | MELBOURNE | ||||||||
| State: | FL | ||||||||
| PostalCode: | 329011500 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8635370848 | ||||||||
| FaxNumber: | 3217337970 | ||||||||
| Practice Location | |||||||||
| Address1: | 308 SOUTH HARBOR CITY BLVD | ||||||||
| Address2: | SUITE C | ||||||||
| City: | MELBOURNE | ||||||||
| State: | FL | ||||||||
| PostalCode: | 329011500 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8635370848 | ||||||||
| FaxNumber: | 3217337970 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/17/2012 | ||||||||
| LastUpdateDate: | 05/14/2012 | ||||||||
| NPIDeactivationReasonCode: | |||||||||
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| ProviderGenderCode: | |||||||||
| AuthorizedOfficialLastName: | MOREL | ||||||||
| AuthorizedOfficialFirstName: | VENECIA | ||||||||
| AuthorizedOfficialMiddleName: | ESTELA | ||||||||
| AuthorizedOfficialTitleorPosition: | CEO/ADMINISTRATOR | ||||||||
| AuthorizedOfficialTelephone: | 8635370848 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
| ParentOrganizationLBN: | |||||||||
| AuthorizedOfficialNamePrefix: | MISS | ||||||||
| AuthorizedOfficialNameSuffix: | |||||||||
| AuthorizedOfficialCredential: | RN | ||||||||
| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 251E00000X | RN9175866 | FL | N | Agencies | Home Health | 253Z00000X | RN9175866 | FL | N | Agencies | In Home Supportive Care | 251J00000X | RN9175866 | FL | Y | Agencies | Nursing Care |
No ID Information.