MEDICARE: YOEL R VIVAS MD PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RC0001X	Clinical Cardiac Electrophysiology Physician	ME112014	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	ME112014	OTHER	FL	MEDICAL LICENSE

General Provider Information

NPI Number	:	1184999807
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	YOEL R VIVAS MD PA

Provider Business Mailing Address
First Line	:	5258 LINTON BLVD STE 106
Second Line	:
City	:	DELRAY BEACH
State	:	FL
Zip	:	33484-6529
Country	:	US
Telephone Number	:	561-303-3491
Fax Number	:	877-248-5240

Provider Business Practice Location Address
First Line	:	5258 LINTON BLVD STE 106
Second Line	:
City	:	DELRAY BEACH
State	:	FL
Zip	:	33484-6529
Country	:	US
Telephone Number	:	561-303-3491
Fax Number	:	877-248-5240

Authorized Official
Title or Position	:	PRESIDENT
Name	:	YOEL R VIVAS
Credential	:	MD
Telephone Number	:	561-303-3491

Provider Enumeration Date	:	03/13/2012
Last Update Date	:	10/31/2022

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