| Organization Name: | VA MEDICAL CENTER |
| NPI Number: | 1063737369 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JASON DEAN HOPPENBROUWER (HUD/VASH CASE MANAGER) |
| Mailing Address: | 2900 Veterans Way Viera |
| State: | FL US |
| Postal Code: | 32940 |
| Phone Number: | 3216373688 |
| Fax Number: | 3216373677 |
| NPI Enumeration Date: | 03/30/2010 |
| NPI Last Update Date: | 03/30/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QV0200X |
| License Number: | SW5603 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | VA |
| Taxonomy Definition: | |