Healthcare Provider Details

I. General information

NPI: 1184793739
Provider Name (Legal Business Name): MIAMI VA HEALTHCARE SYSTEM
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/07/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6039 COLLINS AVE APT 1632
MIAMI BEACH FL
33140-2256
US

IV. Provider business mailing address

6039 COLLINS AVE APT 1632
MIAMI BEACH FL
33140-2256
US

V. Phone/Fax

Practice location:
  • Phone: 305-861-7697
  • Fax:
Mailing address:
  • Phone: 305-861-7697
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License NumberME 96966
License Number StateFL

VIII. Authorized Official

Name: DR. JOHN VARA
Title or Position: MEDICAL CHIEF OF STAFF
Credential: M.D
Phone: 305-324-4455