Healthcare Provider Details

I. General information

NPI: 1922936244
Provider Name (Legal Business Name): VIDA SAUDE TELEHEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/08/2026
Last Update Date: 05/08/2026
Certification Date: 05/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17840 NW 59TH AVE UNIT 101
HIALEAH FL
33015-5161
US

IV. Provider business mailing address

17840 NW 59TH AVE UNIT 101
HIALEAH FL
33015-5161
US

V. Phone/Fax

Practice location:
  • Phone: 786-552-2921
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: JOSE ANTONIO ESTEVEZ LOZADA
Title or Position: OWNER
Credential:
Phone: 786-552-2921