| Vida Med Center Llc | |
|
5881 Nw 151st St Ste 201 Miami Lakes FL 33014-2442 | |
| (305) 725-9416 | |
| Not Available |
| Full Name | Vida Med Center Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 5881 Nw 151st St Ste 201, Miami Lakes, Florida |
| Authorized Official Name and Position | Jose Ramon Garcia Yanes (PRESIDENT) |
| Authorized Official Contact | 3057259416 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Vida Med Center Llc 5881 Nw 151st St Ste 201 Miami Lakes FL 33014-2442 Ph: (305) 725-9416 | Vida Med Center Llc 5881 Nw 151st St Ste 201 Miami Lakes FL 33014-2442 Ph: (305) 725-9416 |
| NPI Number | 1629811633 |
|---|---|
| Provider Enumeration Date | 06/17/2024 |
| Last Update Date | 06/17/2024 |
| Medicare PECOS PAC ID | 0042757908 |
|---|---|
| Medicare Enrollment ID | O20240808004597 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629811633 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
| Provider Name | Tara Howard |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1316688260 PECOS PAC ID: 4183004740 Enrollment ID: I20231207000240 |
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