Provider Demographics
NPI:1699060434
Name:VATELY, NATASHA (LPN)
Entity type:Individual
Prefix:MS
First Name:NATASHA
Middle Name:
Last Name:VATELY
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4850 SW 63RD TER APT 312
Mailing Address - Street 2:
Mailing Address - City:DAVIE
Mailing Address - State:FL
Mailing Address - Zip Code:33314-4435
Mailing Address - Country:US
Mailing Address - Phone:954-793-9214
Mailing Address - Fax:
Practice Address - Street 1:4850 SW 63RD TER APT 312
Practice Address - Street 2:
Practice Address - City:DAVIE
Practice Address - State:FL
Practice Address - Zip Code:33314-4435
Practice Address - Country:US
Practice Address - Phone:954-793-9214
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-09
Last Update Date:2011-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor