# VIDA THERAPY INC

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

## Provider details

- **NPI number:** 1962876557
- **Authorized official:** AYREMIS RODRIGUEZ MA (PRESIDENT)
- **Authorized official phone:** (786) 227-6177

## Contact information

- **Practice address:** 9847 SW 184TH ST, PALMETTO BAY, FL 33157-6934
- **Practice address phone:** (786) 227-6177
- **Practice address fax:** (786) 842-3608
- **Mailing address:** 11285 SW 211TH ST STE 207, CUTLER BAY, FL 33189-2211
- **Mailing address phone:** (786) 227-6177
- **Mailing address fax:** (786) 842-3608

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208D00000X | General Practice Physician | — | — | Yes |
| 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