Vida Medical Centers Of Sweetwater | |
10920 W Flagler St Ste 201 Miami FL 33174-1243 | |
(786) 623-3915 | |
(786) 623-3916 |
Full Name | Vida Medical Centers Of Sweetwater |
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Speciality | Clinic/Center |
Location | 10920 W Flagler St Ste 201, Miami, Florida |
Authorized Official Name and Position | Sandy Lopez (OWNER) |
Authorized Official Contact | 7866233915 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Vida Medical Centers Of Sweetwater 10920 W Flagler St Ste 201 Miami FL 33174-1243 Ph: (786) 623-3915 | Vida Medical Centers Of Sweetwater 10920 W Flagler St Ste 201 Miami FL 33174-1243 Ph: (786) 623-3915 |
NPI Number | 1588294607 |
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Provider Enumeration Date | 01/16/2020 |
Last Update Date | 01/25/2022 |
Medicare PECOS PAC ID | 3274962030 |
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Medicare Enrollment ID | O20200331001905 |
Identifier | Type | State | Issuer |
---|---|---|---|
1588294607 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208D00000X | General Practice | (* (Not Available)) | Secondary |
261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
Provider Name | Juan M Velazquez |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1447522438 PECOS PAC ID: 6901054790 Enrollment ID: I20120920000290 |
Provider Name | Omar Abreu-pino |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1891190526 PECOS PAC ID: 1850467820 Enrollment ID: I20150319001926 |
Provider Name | Cesar L Goya |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1326552431 PECOS PAC ID: 9133482433 Enrollment ID: I20180419002359 |
Provider Name | Ayssa Grillo |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1518446525 PECOS PAC ID: 8022431980 Enrollment ID: I20220124001823 |
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