Healthcare Provider Details

I. General information

NPI: 1760081640
Provider Name (Legal Business Name): V & L MEDICAL CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/21/2020
Last Update Date: 01/12/2025
Certification Date: 01/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10300 SW 72ND ST STE 282
MIAMI FL
33173-3035
US

IV. Provider business mailing address

10300 SW 72ND ST STE 282
MIAMI FL
33173-3035
US

V. Phone/Fax

Practice location:
  • Phone: 305-456-6674
  • Fax: 305-456-5215
Mailing address:
  • Phone: 305-456-6674
  • Fax: 305-456-5215

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: VICTOR I CASTILLO
Title or Position: PRESIDENT
Credential:
Phone: 305-456-6674