Healthcare Provider Details

I. General information

NPI: 1720708217
Provider Name (Legal Business Name): VIMANI LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/02/2022
Last Update Date: 09/02/2022
Certification Date: 09/02/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

441 NW 12TH AVE
MIAMI FL
33128-1020
US

IV. Provider business mailing address

1 TURTLE WALK
KEY BISCAYNE FL
33149-1915
US

V. Phone/Fax

Practice location:
  • Phone: 305-456-5846
  • Fax: 305-200-3152
Mailing address:
  • Phone: 305-607-0164
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: YESSICA GONZALEZ
Title or Position: OWNER
Credential:
Phone: 305-607-0164