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NPI Code Detail

MEDICARE: VIDA HEALTH CARE

MEDICARE: VIDA HEALTH CARE
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
1207Q00000XFamily Medicine Physician

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1811532658
Entity Type Code : Organization
Provider Name (Legal Business Name) : VIDA HEALTH CARE
Provider Business Mailing Address
First Line : 881 E 2ND AVE
Second Line :
City : HIALEAH
State : FL
Zip : 33010-4205
Country : US
Telephone Number : 305-882-1100
Fax Number : 305-503-7292
Provider Business Practice Location Address
First Line : 881 E 2ND AVE
Second Line :
City : HIALEAH
State : FL
Zip : 33010-4205
Country : US
Telephone Number : 305-882-1100
Fax Number : 305-503-7292
Authorized Official
Title or Position : VP
Name : RUBEL RODRIGUEZ
Credential : OTHER
Telephone Number : 305-570-5235
Provider Enumeration Date : 11/15/2019
Last Update Date : 08/02/2024

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Directions to “VIDA HEALTH CARE ” Practice Location

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