Organization
IRIS VIVAS MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
IRIS VIVAS M.D. (OWNER/PRESIDENT)
(305) 559-7996
Entity
Organization
Contact information
Practice address
1835 E HALLANDALE BEACH BLVD, SUITE 134, HALLANDALE BEACH, FL 33009-4619
(305) 559-7996
Mailing address
1835 E HALLANDALE BEACH BLVD, SUITE 134, HALLANDALE BEACH, FL 33009-4619
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
ME107439
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ME107439
LICENSE
FL
Enumeration date
02/05/2016
Last updated
02/05/2016
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