Healthcare Provider Details

I. General information

NPI: 1861884496
Provider Name (Legal Business Name): VELPEM MEDICAL CENTER CORP.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/18/2015
Last Update Date: 08/14/2026
Certification Date: 08/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4055 NW 97TH AVE STE 100
DORAL FL
33178-2911
US

IV. Provider business mailing address

4055 NW 97TH AVE STE 100
DORAL FL
33178-2911
US

V. Phone/Fax

Practice location:
  • Phone: 786-801-1945
  • Fax: 786-558-8190
Mailing address:
  • Phone: 786-801-1945
  • Fax: 786-558-8190

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number StateNULL

VIII. Authorized Official

Name: VIVIANKA LAVIN
Title or Position: DIRECTOR
Credential:
Phone: 305-322-0260