Provider Demographics
NPI:1992403562
Name:VITAS MEDICAL CENTER INC
Entity type:Organization
Organization Name:VITAS MEDICAL CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:YOSDANI
Authorized Official - Middle Name:
Authorized Official - Last Name:RODRIGUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-350-0322
Mailing Address - Street 1:5040 NW 7TH ST STE 750
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33126-3490
Mailing Address - Country:US
Mailing Address - Phone:786-359-4013
Mailing Address - Fax:786-547-5205
Practice Address - Street 1:5040 NW 7TH ST STE 750
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33126-3490
Practice Address - Country:US
Practice Address - Phone:786-359-4013
Practice Address - Fax:786-547-5205
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-22
Last Update Date:2024-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL117215700Medicaid