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Organization

VITAL MEDICAL CENTER INC

Active
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Organization

VITAL MEDICAL CENTER INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
FERNANDO JOSE LORA MD (MD)
(305) 220-0300
Entity
Organization

Contact information

Practice address
8300 WEST FLASLER STREET, SUITE #175, MIAMI, FL 33144-2098
(305) 220-0300
(305) 220-1472
Mailing address
8300 W FLAGLER ST, SUITE #175, MIAMI, FL 33144-6000
(305) 220-0300
(305) 220-1472

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
ME0045837
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0125792
AETNA
05
042148100
FL
01
96904
BLUE CROSS BLUE SHIELD
FL
Enumeration date
04/07/2006
Last updated
03/29/2017
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