Provider Demographics
NPI:1417786278
Name:VIDAL HEALING MINDS CORP
Entity type:Organization
Organization Name:VIDAL HEALING MINDS CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MISS
Authorized Official - First Name:MELVA
Authorized Official - Middle Name:R
Authorized Official - Last Name:REVE URGELLES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-498-9894
Mailing Address - Street 1:15460 SW 82ND LN
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33193-5006
Mailing Address - Country:US
Mailing Address - Phone:305-498-9894
Mailing Address - Fax:
Practice Address - Street 1:15460 SW 82ND LN
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33193-5006
Practice Address - Country:US
Practice Address - Phone:305-498-9894
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-30
Last Update Date:2024-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty