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VIDALIFE MEDICAL SERVICE CENTER CORP NPI 1255907929


NPI Information

NPI: 1255907929
Provider Name: VIDALIFE MEDICAL SERVICE CENTER CORP
Classification: Clinic/Center - 261QP2300X
Entity Type: Organization

Specialization: Primary Care

CLIA Number: 10D2232690

Address:
1380 NE MIAMI GARDENS DR STE 130
MIAMI, FL
ZIP 33179
Phone: (305) 956-7755
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VIDALIFE MEDICAL SERVICE CENTER CORP is a primary care clinic center in Miami, FL. VIDALIFE MEDICAL SERVICE CENTER CORP NPI is 1255907929. The provider is registered as an organization entity type.

The provider's business location address is:

1380 NE MIAMI GARDENS DR STE 130
MIAMI, FL
ZIP 33179-744
Phone: (305) 956-7755

The provider's authorized official is Cesar Bringas .
The authorized official title is President and has the following contact phone number (305) 956-7755.

The CLIA number assigned to this NPI record is 10D2232690 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 6/2/2021 and was last updated on 2/22/2022.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261QP2300XClinic/CenterPrimary CareYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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