| Vital Healthcare Centers Corp | |
|
1601 N Palm Ave Ste 102 Pembroke Pines FL 33026-3240 | |
| (646) 342-5508 | |
| Not Available |
| Full Name | Vital Healthcare Centers Corp |
|---|---|
| Speciality | Clinic/Center |
| Location | 1601 N Palm Ave Ste 102, Pembroke Pines, Florida |
| Authorized Official Name and Position | Ernesto Chavez (OWNER/ ADMINISTRATOR) |
| Authorized Official Contact | 6463425508 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Vital Healthcare Centers Corp 1601 N Palm Ave Ste 102 Pembroke Pines FL 33026-3240 Ph: (646) 342-5508 | Vital Healthcare Centers Corp 1601 N Palm Ave Ste 102 Pembroke Pines FL 33026-3240 Ph: (646) 342-5508 |
| NPI Number | 1871337352 |
|---|---|
| Provider Enumeration Date | 06/20/2024 |
| Last Update Date | 06/20/2024 |
| Medicare PECOS PAC ID | 3173058930 |
|---|---|
| Medicare Enrollment ID | O20241203001964 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1871337352 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
| Provider Name | Julian Diavanti |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1871800664 PECOS PAC ID: 3678711470 Enrollment ID: I20170816004027 |
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