| Vitality Center Inc | |
|
8348 Bird Rd Miami FL 33155-3354 | |
| (305) 741-9565 | |
| (305) 397-1714 |
| Full Name | Vitality Center Inc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 8348 Bird Rd, Miami, Florida |
| Authorized Official Name and Position | Carlos Antonio Santana (PRESIDENT) |
| Authorized Official Contact | 7864619959 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Vitality Center Inc 8950 Sw 152nd St Palmetto Bay FL 33157-1901 Ph: (305) 741-9565 | Vitality Center Inc 8348 Bird Rd Miami FL 33155-3354 Ph: (305) 741-9565 |
| NPI Number | 1790399053 |
|---|---|
| Provider Enumeration Date | 09/03/2020 |
| Last Update Date | 01/26/2023 |
| Certification Date | 01/26/2023 |
| Medicare PECOS PAC ID | 8325427164 |
|---|---|
| Medicare Enrollment ID | O20220624000382 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790399053 | NPI | - | NPPES |
| Provider Name | Carlos Jacinto Martinez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487011557 PECOS PAC ID: 1355632720 Enrollment ID: I20161018000006 |
| Provider Name | Roberto E Gimenez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508239872 PECOS PAC ID: 9830485291 Enrollment ID: I20170510002168 |
| Provider Name | Sander Fernandez |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1922394485 PECOS PAC ID: 7618197161 Enrollment ID: I20171006000397 |
| Provider Name | Sabih Iqbal |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1205330024 PECOS PAC ID: 5395141097 Enrollment ID: I20210903001578 |
| Provider Name | Juan M Guzman Otero |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992314058 PECOS PAC ID: 7618365362 Enrollment ID: I20211028002322 |
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