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General NPI Number Information
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NPI Number | 1235953845
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Entity Type | Organization
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Legal Business Name | VILIV HEALTH
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Dates
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Enumeration Date | 11/11/2024
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Last Update Date | 01/21/2025
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Provider Practice Location Address
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Address Line | 900 SW 97TH AVE
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City | MIAMI
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State | FL
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Zip | 33174-2935
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Country | US
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Telephone | 786-507-5530
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Fax |
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Provider Business Mailing Address
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Address Line | 12934 SW 285TH TER
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City | HOMESTEAD
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State | FL
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Zip | 33033-1997
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Country | US
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Telephone | 786-539-6221
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | RICARDO ANTONIO IVONNET GALBAN
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Credential |
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Telephone | 786-539-6221
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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