VITIA ANGELA PACK LICENSED MASSAGE THE NPI 1013133826

Physician Assistant in Davie, FL

NPI 1013133826 Individual Female Years of Experience 11 Physician Assistant PECOS Enrolled Accepts Medicare Approved Payment

About VITIA PACK

Vitia Pack is a primary care provider established in Davie, Florida and her medical specialization is physician assistant with more than 11 years of experience. The NPI number of Vitia Pack is 1013133826 and was assigned on April 2007. The practitioner's primary taxonomy code is 363A00000X with license number PA9106235 (FL). The provider is registered as an individual and her NPI record was last updated 2 years ago.

A primary care provider (PCP) like Vitia Angela Pack Licensed Massage The sees people with common medical problems. The primary care provider might be a doctor, physician assistant, nurse practitioner or clinic that are usually involved in your long-term care. A PCP might provide preventive care, treat common medical conditions, identify urgent medical problems and refer you to specialists when necessary. Primary care is usually provided in an outpatient facility but if you are admitted to a hospital your PCP may assist in your care. The most common medical conditions seen by primary care providers are: hypertension, upper respiratory tract infections, depression or anxiety, back pain, arthritis, dermatitis, diabetes, urinary tract infections, etc

Vitia Pack is enrolled in PECOS and is eligible to order or refer healthcare services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices

Vitia Pack is registered with Medicare and accepts claims assignment, this means the provider accepts Medicare's approved amount for the cost of rendered services as full payment. Participating providers may not charge Medicare beneficiaries more than Medicare's approved amount for their services. Medicare beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.

NPI

1013133826

Provider Name VITIA ANGELA PACK LICENSED MASSAGE THE
Provider Location Address4780 SW 64TH AVE STE 101 DAVIE, FL 33314
Provider Mailing Address4780 SW 64TH AVE STE 103 DAVIE, FL 33314
GenderFemale
NPI Entity TypeIndividual
Medical School NameOTHER
Graduation Year2011
Is Sole Proprietor?No
Is Organization Subpart?N/A
Enumeration Date04-18-2007
Last Update Date01-06-2020


Primary Taxonomy

Taxonomy Code363A00000X
ClassificationPhysician Assistant
TypePhysician Assistants & Advanced Practice Nursing Providers
License No.PA9106235
License StateFL
Taxonomy DescriptionA physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

Business Address

VITIA ANGELA PACK LICENSED MASSAGE THE
4780 SW 64TH AVE STE 101
DAVIE, FL
ZIP 33314
Phone: (954) 434-1705
Fax: (954) 434-1882

Get Directions


Mailing Address

VITIA ANGELA PACK LICENSED MASSAGE THE
4780 SW 64TH AVE STE 103
DAVIE, FL
ZIP 33314
Phone: (954) 434-1705
Fax: (954) 434-1882



Secondary Taxonomies


The secondary taxonomy codes define the provider type, classification, and specialization. For individual NPIs the license data is associated to each taxonomy code.

No. Taxonomy Code Type Classification Specialization License No. State Primary
1225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistNo

Taxonomy Description: an individual trained in the manipulation of tissues (as by rubbing, stroking, kneading, or tapping) with the hand or an instrument for remedial or hygienic purposes.

Additional Identifiers


Additional identifier(s) currently or formerly used as an identifier for the provider. The codes may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State
MA31540OTHER (01)FL

Other Providers at the same location


The following 6 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1609823632ASSOCIATES IN FAMILY PRACTICE OF BROWARD LLC
Organization
Family Medicine4780 SW 64TH AVE STE 101
DAVIE, FL 33314
(954) 434-1705
1861577025DR. DAVID IRA OLINSKY DPM
Individual
Podiatrist4780 SW 64TH AVE STE 101
DAVIE, FL 33314
(954) 434-1705
1619491859 LEONILA ABAN ENGELMANN APRN
Individual
Nurse Practitioner (Family)4780 SW 64TH AVE STE 101
DAVIE, FL 33314
(954) 434-1705
1275570020 MATTHEW TELTSER MD
Individual
Internal Medicine (Cardiovascular Disease)4780 SW 64TH AVE STE 101
DAVIE, FL 33314
(954) 434-1705
1558900472ASSOCIATESMD MEDICAL GROUP INC
Organization
Family Medicine4780 SW 64TH AVE STE 101
DAVIE, FL 33314
(954) 434-1705
1174762454 DEBORAH JANE KUIPER-TOMAS PA-C
Individual
Family Medicine4780 SW 64TH AVE STE 101
DAVIE, FL 33314
(954) 434-1705

NPI Footnotes

What is the National Provider Indentifier (NPI)?
The NPI is 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.

Provider Location Address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.

Provider Mailing Address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.

Entity Type Code
The code describing the type of health care provider that is being assigned an NPI.
The entity type codes are:
1 = Person: individual human being who furnishes health care;
2 = Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)

What is a Subpart?
Subparts are the components and separate physical locations of organization health care providers. Subpart examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.

Provider Other Organization Name
The other organization name is the alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. The provider other organization name codes are:
1 = former name;
2 = professional name;
3 = doing business as (d/b/ a) name;
4 = former legal business name; :
5 = other.

Provider Enumeration Date
The date the provider was assigned a unique identifier (assigned an NPI).

Last Update Date
The date that a NPI record was last updated or changed.

Primary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Authorized Official Name
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.