Healthcare Provider Details

I. General information

NPI: 1649104936
Provider Name (Legal Business Name): VIVACARE TRANSPORTATION LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/11/2026
Last Update Date: 06/11/2026
Certification Date: 06/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19811 SW 119TH AVE
MIAMI FL
33177-4329
US

IV. Provider business mailing address

19811 SW 119TH AVE
MIAMI FL
33177-4329
US

V. Phone/Fax

Practice location:
  • Phone: 786-222-0994
  • Fax:
Mailing address:
  • Phone: 786-222-0994
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State

VIII. Authorized Official

Name: LAZARO VALDES
Title or Position: CEO
Credential: VALDES
Phone: 786-222-0994