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NPI Code Detail

MEDICARE: VELPEM MEDICAL CENTER CORP.

MEDICARE: VELPEM MEDICAL CENTER CORP.
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
1207Q00000XFamily Medicine Physician

General Provider Information

NPI Number : 1861884496
Entity Type Code : Organization
Provider Name (Legal Business Name) : VELPEM MEDICAL CENTER CORP.
Provider Business Mailing Address
First Line : 4055 NW 97TH AVE STE 100
Second Line :
City : DORAL
State : FL
Zip : 33178-2911
Country : US
Telephone Number : 786-801-1945
Fax Number : 786-558-8190
Provider Business Practice Location Address
First Line : 4055 NW 97TH AVE STE 100
Second Line :
City : DORAL
State : FL
Zip : 33178-2911
Country : US
Telephone Number : 786-801-1945
Fax Number : 786-558-8190
Authorized Official
Title or Position : DIRECTOR
Name : VIVIANKA LAVIN
Credential :
Telephone Number : 305-322-0260
Provider Enumeration Date : 02/18/2015
Last Update Date : 10/16/2024

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Directions to “VELPEM MEDICAL CENTER CORP. ” Practice Location

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