Vda Community Center Corp | |
14247 Sw 42nd St Unit 15 Miami FL 33175-6408 | |
(786) 817-2976 | |
(786) 431-2567 |
Full Name | Vda Community Center Corp |
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Speciality | Clinic/Center |
Location | 14247 Sw 42nd St Unit 15, Miami, Florida |
Authorized Official Name and Position | Felix Barrera Morales (PRESIDENT) |
Authorized Official Contact | 7868936168 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Vda Community Center Corp 14247 Sw 42nd St Unit 15 Miami FL 33175-6408 Ph: (786) 817-2976 | Vda Community Center Corp 14247 Sw 42nd St Unit 15 Miami FL 33175-6408 Ph: (786) 817-2976 |
NPI Number | 1669065892 |
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Provider Enumeration Date | 02/18/2021 |
Last Update Date | 09/13/2023 |
Certification Date | 09/13/2023 |
Medicare PECOS PAC ID | 5991182735 |
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Medicare Enrollment ID | O20220516002409 |
Identifier | Type | State | Issuer |
---|---|---|---|
1669065892 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
Provider Name | Raja Moti Gidwani |
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Provider Type | Practitioner - Pathology |
Provider Identifiers | NPI Number: 1235165051 PECOS PAC ID: 6608047014 Enrollment ID: I20110915000268 |
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