Healthcare Provider Details

I. General information

NPI: 1275473688
Provider Name (Legal Business Name): VIDA DIGNA HOME CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/30/2026
Last Update Date: 03/30/2026
Certification Date: 03/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2948 SW 25TH ST
MIAMI FL
33133-2106
US

IV. Provider business mailing address

2948 SW 25TH ST
MIAMI FL
33133-2106
US

V. Phone/Fax

Practice location:
  • Phone: 786-856-9973
  • Fax: 786-856-9973
Mailing address:
  • Phone: 786-856-9973
  • Fax: 786-856-9973

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: MARY DANIA D GONZALEZ
Title or Position: CNA
Credential:
Phone: 786-856-9973