Individual
JOSE ALBERTO VIDAL GARCIA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1905 NW 82ND AVE, DORAL, FL 33126-1011
(786) 420-5924
Mailing address
1905 NW 82ND AVE, DORAL, FL 33126-1011
(786) 420-5924
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
CBHCMP100327
FL
Other
Enumeration date
02/07/2020
Last updated
02/07/2020
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