| Fuerza Vital Medical Institute, Corp | |
|
3701 Sw 107th Ave Miami FL 33165-3638 | |
| (305) 553-8343 | |
| (305) 640-8537 |
| Full Name | Fuerza Vital Medical Institute, Corp |
|---|---|
| Speciality | Behavior Analyst |
| Location | 3701 Sw 107th Ave, Miami, Florida |
| Authorized Official Name and Position | Luis Manuel Benitez Vila (PRESIDENT) |
| Authorized Official Contact | 3056408530 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Fuerza Vital Medical Institute, Corp 3701 Sw 107th Ave Miami FL 33165-3638 Ph: (305) 553-8343 | Fuerza Vital Medical Institute, Corp 3701 Sw 107th Ave Miami FL 33165-3638 Ph: (305) 553-8343 |
| NPI Number | 1083113054 |
|---|---|
| Provider Enumeration Date | 02/06/2018 |
| Last Update Date | 06/11/2024 |
| Certification Date | 06/11/2024 |
| Medicare PECOS PAC ID | 0749689743 |
|---|---|
| Medicare Enrollment ID | O20210525000225 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083113054 | NPI | - | NPPES |
| Provider Name | Guillermo A Fonseca |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1972700714 PECOS PAC ID: 8325308943 Enrollment ID: I20180130002505 |
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