MEDICARE: V L HEALTH MEDICAL CENTER INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RG0100X	Gastroenterology Physician
2	207Q00000X	Family Medicine Physician

General Provider Information

NPI Number	:	1194753061
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	V L HEALTH MEDICAL CENTER INC

Provider Business Mailing Address
First Line	:	2141 NW 7TH ST
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33125-3483
Country	:	US
Telephone Number	:	305-642-2345
Fax Number	:	305-642-2615

Provider Business Practice Location Address
First Line	:	2141 NW 7TH ST
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33125-3483
Country	:	US
Telephone Number	:	305-642-2345
Fax Number	:	305-642-2615

Authorized Official
Title or Position	:	OWNER
Name	:	CARMEN E NUNEZ
Credential	:
Telephone Number	:	305-642-2345

Provider Enumeration Date	:	06/29/2006
Last Update Date	:	12/12/2008

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Directions to “V L HEALTH MEDICAL CENTER INC ” Practice Location

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