Organization
VIDA GROUP SERVICES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VICTOR RAMON CASTILLO (PRESIDENT)
(786) 768-4882
Entity
Organization
Contact information
Practice address
777 NW 72ND AVE, SUITE 3157, MIAMI, FL 33126-3009
(786) 712-7312
(305) 675-5755
Mailing address
777 NW 72ND AVE, SUITE 3157, MIAMI, FL 33126-3009
(786) 712-7312
(305) 675-5755
Taxonomy
Speciality
Code
Description
License number
State
111NR0200X
Radiology Chiropractor
Primary
—
—
111NX0800X
Orthopedic Chiropractor
—
—
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
—
—
208100000X
Physical Medicine & Rehabilitation Physician
—
—
Other
Enumeration date
03/16/2009
Last updated
09/02/2009
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