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General NPI Number Information
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NPI Number | 1871019729
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Entity Type | Organization
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Legal Business Name | VIVA WELLNESS & INJURY, LLC
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Dates
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Enumeration Date | 08/22/2017
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Last Update Date | 10/16/2019
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Provider Practice Location Address
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Address Line | 7780 LAKE UNDERHILL RD STE 109
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City | ORLANDO
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State | FL
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Zip | 32822-8218
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Country | US
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Telephone | 407-350-5075
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Fax | 407-350-5089
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Provider Business Mailing Address
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Address Line | 5703 RED BUG LAKE RD # 310
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City | WINTER SPRINGS
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State | FL
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Zip | 32708-4969
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Country | US
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Telephone | 407-350-5075
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Fax | 407-350-5089
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | EDWIN MEJIAS
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Credential |
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Telephone | 407-493-3979
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208VP0014X
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Taxonomy Name | Interventional Pain Medicine Physician
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License Number |
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License Number State |
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