Organization
VIDA MEDICAL CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
YACCELY E HERNANDEZ I (AUTHORIZED OFFICIAL)
(305) 227-6161
Entity
Organization
Contact information
Practice address
8420 W FLAGLER ST STE 218, MIAMI, FL 33144-2046
(305) 222-5005
Mailing address
8880 NW 20TH ST STE J, DORAL, FL 33172-2636
(305) 227-6161
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
ME66588
FL
Other
Enumeration date
12/09/2013
Last updated
12/09/2013
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