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Organization
VIDA THERAPY INC
Active
Organization
VIDA THERAPY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AYREMIS RODRIGUEZ MA (PRESIDENT)
(786) 227-6177
Entity
Organization
Contact information
Practice address
9847 SW 184TH ST, PALMETTO BAY, FL 33157-6934
(786) 227-6177
(786) 842-3608
Mailing address
11285 SW 211TH ST STE 207, CUTLER BAY, FL 33189-2211
(786) 227-6177
(786) 842-3608
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
—
251B00000X
Case Management Agency
—
—
251S00000X
Community/Behavioral Health Agency
—
—
261QH0100X
Health Service Clinic/Center
—
—
261QP2000X
Physical Therapy Clinic/Center
—
—
261QP2300X
Primary Care Clinic/Center
—
—
Other
Enumeration date
11/19/2015
Last updated
11/08/2021
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