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Organization

VIDA VITAL LLC

Active
Other names
vida medical services
Organization subpart
No

Provider details

NPI number
Authorized official
YAILEN BENGOCHEA (PRESIDENT)
(786) 256-9747
Entity
Organization

Contact information

Practice address
1490 W 68TH ST, 201, HIALEAH, FL 33014-4590
(786) 256-9747
Mailing address
1490 W 68TH ST, 201, HIALEAH, FL 33014-4590
(786) 256-9747

Taxonomy

Speciality
Code
Description
License number
State
173000000X
Legal Medicine
Primary
HCC7020
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
HCC7020
HEALTH DEPT LICENSE
FL
Enumeration date
07/02/2006
Last updated
08/22/2020
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