Provider Demographics
NPI:1861884496
Name:VELPEM MEDICAL CENTER CORP.
Entity type:Organization
Organization Name:VELPEM MEDICAL CENTER CORP.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:VIVIANKA
Authorized Official - Middle Name:
Authorized Official - Last Name:LAVIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-322-0260
Mailing Address - Street 1:4055 NW 97TH AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:DORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33178-2911
Mailing Address - Country:US
Mailing Address - Phone:786-801-1945
Mailing Address - Fax:786-558-8190
Practice Address - Street 1:4055 NW 97TH AVE STE 100
Practice Address - Street 2:
Practice Address - City:DORAL
Practice Address - State:FL
Practice Address - Zip Code:33178-2911
Practice Address - Country:US
Practice Address - Phone:786-801-1945
Practice Address - Fax:786-558-8190
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-18
Last Update Date:2024-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine