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General NPI Number Information
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NPI Number | 1770255549
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Entity Type | Organization
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Legal Business Name | VACA IN HOSPITAL ENTERPRISES. INC
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Dates
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Enumeration Date | 09/30/2021
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Last Update Date | 09/30/2021
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Provider Practice Location Address
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Address Line | 8260 W FLAGLER ST STE 2J
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City | MIAMI
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State | FL
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Zip | 33144-2069
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Country | US
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Telephone | 305-229-0551
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Fax | 305-229-1823
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Provider Business Mailing Address
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Address Line | 8260 W FLAGLER ST STE 2J
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City | MIAMI
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State | FL
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Zip | 33144-2069
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Country | US
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Telephone | 305-229-0551
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | CARLOS E VACA
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Credential | MD
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Telephone | 305-229-0551
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RA0401X
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Taxonomy Name | Addiction Medicine (Internal Medicine) Physician
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License Number |
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License Number State |
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