| Vidalife Medical Service Center Corp | |
|
1380 Ne Miami Gardens Dr Ste 130 Miami FL 33179-4744 | |
| (305) 956-7755 | |
| Not Available |
| Full Name | Vidalife Medical Service Center Corp |
|---|---|
| Speciality | Clinic/Center |
| Location | 1380 Ne Miami Gardens Dr Ste 130, Miami, Florida |
| Authorized Official Name and Position | Cesar Bringas (PRESIDENT) |
| Authorized Official Contact | 3059567755 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Vidalife Medical Service Center Corp 1380 Ne Miami Gardens Dr Ste 130 Miami FL 33179-4744 Ph: (305) 956-7755 | Vidalife Medical Service Center Corp 1380 Ne Miami Gardens Dr Ste 130 Miami FL 33179-4744 Ph: (305) 956-7755 |
| NPI Number | 1255907929 |
|---|---|
| Provider Enumeration Date | 06/02/2021 |
| Last Update Date | 02/22/2022 |
| Medicare PECOS PAC ID | 3870971484 |
|---|---|
| Medicare Enrollment ID | O20220609000672 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255907929 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
| Provider Name | Julio De Pena |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1679776330 PECOS PAC ID: 1759459134 Enrollment ID: I20081013000314 |
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