MEDICARE: HELEN CARIDAD VIDAL PA-C

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	363A00000X	Physician Assistant	PA9119326	FL

General Provider Information

NPI Number	:	1891491320
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HELEN CARIDAD VIDAL PA-C

Provider Business Mailing Address
First Line	:	5955 PONCE DE LEON BLVD
Second Line	:
City	:	CORAL GABLES
State	:	FL
Zip	:	33146-2423
Country	:	US
Telephone Number	:	305-661-1515
Fax Number	:	305-662-3723

Provider Business Practice Location Address
First Line	:	5955 PONCE DE LEON BLVD
Second Line	:
City	:	CORAL GABLES
State	:	FL
Zip	:	33146-2423
Country	:	US
Telephone Number	:	305-661-1515
Fax Number	:	786-533-9518

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/06/2023
Last Update Date	:	12/04/2025

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Directions to “ HELEN CARIDAD VIDAL PA-C” Practice Location

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