MEDICARE: UNIVIDA MEDICAL CENTER LLC

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	208D00000X	General Practice Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1487321774
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	UNIVIDA MEDICAL CENTER LLC

Provider Business Mailing Address
First Line	:	4353 NW 77TH AVE FL 3
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33166-6736
Country	:	US
Telephone Number	:	305-204-0333
Fax Number	:	305-359-7546

Provider Business Practice Location Address
First Line	:	6400 SW 8TH ST
Second Line	:
City	:	WEST MIAMI
State	:	FL
Zip	:	33144-4814
Country	:	US
Telephone Number	:	305-204-0333
Fax Number	:	305-359-7546

Authorized Official
Title or Position	:	MANAGING PARTNER
Name	:	LUIS CASTRO
Credential	:
Telephone Number	:	305-204-0333

Provider Enumeration Date	:	08/25/2021
Last Update Date	:	12/04/2025

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Directions to “UNIVIDA MEDICAL CENTER LLC ” Practice Location

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