MEDICARE: VIDA DEL SOL WELLNESS

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	103TA0400X	Addiction (Substance Use Disorder) Psychologist
2	103TC0700X	Clinical Psychologist
3	2084A0401X	Addiction Medicine (Psychiatry & Neurology) Physician
4	103TC2200X	Clinical Child & Adolescent Psychologist
5	106H00000X	Marriage & Family Therapist
6	101Y00000X	Counselor
7	207Q00000X	Family Medicine Physician
8	1041C0700X	Clinical Social Worker
9	103TP2701X	Group Psychotherapy Psychologist
10	2083A0300X	Addiction Medicine (Preventive Medicine) Physician
11	2084P0800X	Psychiatry Physician
12	363LP0808X	Psychiatric/Mental Health Nurse Practitioner
13	2084P0804X	Child & Adolescent Psychiatry Physician
14	2084P0805X	Geriatric Psychiatry Physician
15	2084P0802X	Addiction Psychiatry Physician

General Provider Information

NPI Number	:	1982595419
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VIDA DEL SOL WELLNESS

Provider Business Mailing Address
First Line	:	316 OSUNA RD NE STE 101
Second Line	:
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87107-5950
Country	:	US
Telephone Number	:	505-645-8055
Fax Number	:

Provider Business Practice Location Address
First Line	:	316 OSUNA RD NE STE 101
Second Line	:
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87107-5950
Country	:	US
Telephone Number	:	505-645-8055
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	PAUL E ROMO
Credential	:	MD
Telephone Number	:	505-645-8055

Provider Enumeration Date	:	07/12/2025
Last Update Date	:	03/24/2026

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Directions to “VIDA DEL SOL WELLNESS ” Practice Location

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