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General NPI Number Information
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NPI Number | 1710856299
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Entity Type | Organization
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Legal Business Name | CLINICA MEDICA VIDA PLUS, LLC
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Dates
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Enumeration Date | 11/03/2025
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Last Update Date | 11/03/2025
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Provider Practice Location Address
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Address Line | 3213 S 24TH ST STE 101B
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City | OMAHA
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State | NE
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Zip | 68108-1832
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Country | US
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Telephone | 402-259-0106
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Fax | 402-259-0107
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Provider Business Mailing Address
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Address Line | 3213 S 24TH ST STE 101B
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City | OMAHA
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State | NE
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Zip | 68108-1832
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Country | US
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Telephone | 402-259-0106
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Fax | 402-259-0107
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Authorized Official
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Title or Position | NP
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Name | JUAN ACOSTA GUZMAN
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Credential |
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Telephone | 786-234-7253
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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