Vida Medical Clinic Llc | |
1960 E Osceola Pkwy Kissimmee FL 34743-8626 | |
(407) 978-6400 | |
(407) 530-4326 |
Full Name | Vida Medical Clinic Llc |
---|---|
Speciality | General Practice |
Location | 1960 E Osceola Pkwy, Kissimmee, Florida |
Authorized Official Name and Position | Karem M Feeley (ADMINISTRATOR) |
Authorized Official Contact | 4079786400 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Vida Medical Clinic Llc 7550 Futures Dr Ste 104 Orlando FL 32819-9096 Ph: (407) 978-6400 | Vida Medical Clinic Llc 1960 E Osceola Pkwy Kissimmee FL 34743-8626 Ph: (407) 978-6400 |
NPI Number | 1356967475 |
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Provider Enumeration Date | 06/24/2020 |
Last Update Date | 05/02/2023 |
Medicare PECOS PAC ID | 8527487610 |
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Medicare Enrollment ID | O20200923000039 |
Identifier | Type | State | Issuer |
---|---|---|---|
1356967475 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208D00000X | General Practice | (* (Not Available)) | Primary |
Provider Name | Carlos J Lugo |
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Provider Type | Practitioner - General Practice |
Provider Identifiers | NPI Number: 1013951797 PECOS PAC ID: 3476563727 Enrollment ID: I20130926000624 |
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