Healthcare Provider Details

I. General information

NPI: 1851166342
Provider Name (Legal Business Name): VIOLET HEALTH CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/15/2023
Last Update Date: 04/23/2026
Certification Date: 04/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10520 NW 26TH ST STE C101
DORAL FL
33172-5941
US

IV. Provider business mailing address

7500 NW 25TH ST STE 210
DORAL FL
33122-1714
US

V. Phone/Fax

Practice location:
  • Phone: 786-712-0004
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: GLEIDYS JIMENEZ
Title or Position: PRESIDENT
Credential:
Phone: 786-712-0004