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General NPI Number Information
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NPI Number | 1386551844
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Entity Type | Organization
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Legal Business Name | VIDAWELL CARE LLC
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Dates
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Enumeration Date | 08/27/2026
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Last Update Date | 08/27/2026
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Provider Practice Location Address
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Address Line | 1911 HARRISON ST STE 8
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City | HOLLYWOOD
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State | FL
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Zip | 33020-5017
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Country | US
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Telephone | 305-395-3561
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Fax | 305-230-7990
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Provider Business Mailing Address
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Address Line | 10700 CARIBBEAN BLVD STE 202-12
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City | CUTLER BAY
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State | FL
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Zip | 33189-1224
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Country | US
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Telephone | 305-395-3561
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Fax | 305-230-7990
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Authorized Official
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Title or Position | OWNER
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Name | MAYARA ORTIZ FERNANDEZ
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Credential |
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Telephone | 786-670-0011
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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