Provider Demographics
NPI:1891532008
Name:VIDA HEALTHCARE SERVICES INC
Entity type:Organization
Organization Name:VIDA HEALTHCARE SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER 11014696
Authorized Official - Prefix:
Authorized Official - First Name:PASCUAL
Authorized Official - Middle Name:
Authorized Official - Last Name:MORA DELGADO
Authorized Official - Suffix:
Authorized Official - Credentials:APRN 11014696
Authorized Official - Phone:786-486-9896
Mailing Address - Street 1:10041 HAITIAN DR
Mailing Address - Street 2:
Mailing Address - City:CUTLER BAY
Mailing Address - State:FL
Mailing Address - Zip Code:33189-1647
Mailing Address - Country:US
Mailing Address - Phone:786-786-9896
Mailing Address - Fax:
Practice Address - Street 1:10041 HAITIAN DR
Practice Address - Street 2:
Practice Address - City:CUTLER BAY
Practice Address - State:FL
Practice Address - Zip Code:33189-1647
Practice Address - Country:US
Practice Address - Phone:786-786-9896
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-15
Last Update Date:2024-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty