Healthcare Provider Details

I. General information

NPI: 1457434136
Provider Name (Legal Business Name): AMADO VIERA, M.D., P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/24/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

777 E 25TH ST STE 219
HIALEAH FL
33013-3850
US

IV. Provider business mailing address

12720 IXORA RD
NORTH MIAMI FL
33181-2359
US

V. Phone/Fax

Practice location:
  • Phone: 305-835-0438
  • Fax: 305-693-0768
Mailing address:
  • Phone: 305-892-2378
  • Fax: 305-892-2378

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberME 0092820
License Number StateFL

VIII. Authorized Official

Name: DR. AMADO VIERA
Title or Position: PRESIDENT
Credential: M.D.
Phone: 305-835-0438