Healthcare Provider Details

I. General information

NPI: 1114510880
Provider Name (Legal Business Name): VIDAL CONCIERGE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/14/2021
Last Update Date: 05/21/2026
Certification Date: 05/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11911 US HIGHWAY 1 STE 301
NORTH PALM BEACH FL
33408-2862
US

IV. Provider business mailing address

11911 US HIGHWAY 1 STE 301
NORTH PALM BEACH FL
33408-2862
US

V. Phone/Fax

Practice location:
  • Phone: 321-320-8472
  • Fax:
Mailing address:
  • Phone: 321-320-8472
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: YAEL VIDAL
Title or Position: MD
Credential:
Phone: 718-559-7108