Provider Demographics
NPI:1306302567
Name:BROCHE FERRER, VITALIA (HHA)
Entity type:Individual
Prefix:
First Name:VITALIA
Middle Name:
Last Name:BROCHE FERRER
Suffix:
Gender:F
Credentials:HHA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21374 SW 112TH AVE APT 301
Mailing Address - Street 2:
Mailing Address - City:CUTLER BAY
Mailing Address - State:FL
Mailing Address - Zip Code:33189-2942
Mailing Address - Country:US
Mailing Address - Phone:786-316-6866
Mailing Address - Fax:
Practice Address - Street 1:21374 SW 112TH AVE APT 301
Practice Address - Street 2:
Practice Address - City:CUTLER BAY
Practice Address - State:FL
Practice Address - Zip Code:33189-2942
Practice Address - Country:US
Practice Address - Phone:786-316-6866
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-13
Last Update Date:2019-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care