| Vida Plus Medical Llc | |
|
339 Cypress Pkwy Ste 250 Kissimmee FL 34759-3315 | |
| (407) 910-1555 | |
| (407) 910-1577 |
| Full Name | Vida Plus Medical Llc |
|---|---|
| Speciality | General Practice |
| Location | 339 Cypress Pkwy Ste 250, Kissimmee, Florida |
| Authorized Official Name and Position | Edwin Nieves (CEO) |
| Authorized Official Contact | 7873630406 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Vida Plus Medical Llc 339 Cypress Pkwy Ste 250 Kissimmee FL 34759-3315 Ph: (407) 910-1555 | Vida Plus Medical Llc 339 Cypress Pkwy Ste 250 Kissimmee FL 34759-3315 Ph: (407) 910-1555 |
| NPI Number | 1992424832 |
|---|---|
| Provider Enumeration Date | 08/24/2022 |
| Last Update Date | 08/24/2022 |
| Medicare PECOS PAC ID | 2961876578 |
|---|---|
| Medicare Enrollment ID | O20230322001985 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992424832 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (* (Not Available)) | Primary |
| Provider Name | Edwin Nieves Hernandez |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1336687656 PECOS PAC ID: 8426486788 Enrollment ID: I20200319001935 |
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