Organization
VITAS INNOVATIVE HOSPICE CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. FIDEL RODRIGUEZ M.D. (TEAM PHYSICIAN)
(407) 670-6400
Entity
Organization
Contact information
Practice address
2075 LOCH LOMOND DR, WINTER PARK, FL 32792-4183
(407) 670-6400
(407) 670-6430
Mailing address
19901 VILLA TUSCANY DR, 105, ORLANDO, FL 32821-4106
(407) 239-6220
(407) 239-6220
Taxonomy
Speciality
Code
Description
License number
State
251G00000X
Community Based Hospice Care Agency
Primary
ME023839
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
49027
—
FL
01
—
ME0023839
STATE LICENSE
FL
Enumeration date
04/24/2007
Last updated
08/22/2020
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