MEDICARE: V&V MEDICAL CENTER

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

General Provider Information

NPI Number	:	1487607305
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	V&V MEDICAL CENTER

Provider Business Mailing Address
First Line	:	4410 W 16TH AVE
Second Line	:	SUITE 26
City	:	HIALEAH
State	:	FL
Zip	:	33012-7100
Country	:	US
Telephone Number	:	305-822-8883
Fax Number	:	305-825-8273

Provider Business Practice Location Address
First Line	:	4410 W 16TH AVE
Second Line	:	SUITE 26
City	:	HIALEAH
State	:	FL
Zip	:	33012-7100
Country	:	US
Telephone Number	:	305-822-8883
Fax Number	:	305-825-8273

Authorized Official
Title or Position	:	OFFICE MANAGER
Name	:	VENUS DE PAZ
Credential	:
Telephone Number	:	305-822-8883

Provider Enumeration Date	:	05/19/2006
Last Update Date	:	08/22/2020

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Directions to “V&V MEDICAL CENTER ” Practice Location

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