Basic Information
| Provider Information | |||||||||
| NPI: | 1811650252 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | VARK INDUSTRIES, INC. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4216 LITTLE RD | ||||||||
| Address2: | |||||||||
| City: | NEW PORT RICKEY | ||||||||
| State: | FL | ||||||||
| PostalCode: | 34655 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7278075618 | ||||||||
| FaxNumber: | 7278075733 | ||||||||
| Practice Location | |||||||||
| Address1: | 4216 LITTLE RD | ||||||||
| Address2: | |||||||||
| City: | NEW PORT RICKEY | ||||||||
| State: | FL | ||||||||
| PostalCode: | 34655 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7278075618 | ||||||||
| FaxNumber: | 7278075733 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/21/2021 | ||||||||
| LastUpdateDate: | 10/21/2021 | ||||||||
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| AuthorizedOfficialLastName: | KABORYCHA | ||||||||
| AuthorizedOfficialFirstName: | VINCENT | ||||||||
| AuthorizedOfficialMiddleName: | A | ||||||||
| AuthorizedOfficialTitleorPosition: | CEO | ||||||||
| AuthorizedOfficialTelephone: | 8137489746 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MR. | ||||||||
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| NPICertificationDate: | 10/21/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RI0200X | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | Infectious Disease |
No ID Information.