# VIDA MEDICAL ALLIANCE, INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1215636022
- **Authorized official:** KAREM M FEELEY (CEO)
- **Authorized official phone:** (813) 431-9787

## Contact information

- **Practice address:** 4130 14TH ST NE, ST PETERSBURG, FL 33703-5328
- **Practice address phone:** (813) 431-9787
- **Practice address fax:** (407) 530-4326
- **Mailing address:** 4130 14TH ST NE, ST PETERSBURG, FL 33703-5328
- **Mailing address phone:** (813) 431-9787
- **Mailing address fax:** (407) 530-4326

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | — | — |
| 207R00000X | Internal Medicine Physician | — | — | — |
| 208D00000X | General Practice Physician | — | — | Yes |

## Other

- **Enumeration date:** 03/01/2023
- **Last updated:** 03/01/2023