Vida Medical Group PA

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

Legal business name

VIDA MEDICAL GROUP PA

Practice address

26847 S Dixie Hwy
Homestead, FL 33032-7524

Phone

(305) 258-9352

Fax

(786) 404-3604

NPI assigned

Nov 6, 2017

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Dagoberto Marquez, APRN11013592NPI 1982273587

Title

Owner

Phone

(786) 586-7645

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Dagoberto Marquez, APRN

  • Primary Care Nurse Practitioner
  • Homestead, FL
  • NPI 1982273587
  Medicare reassignment Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1509926400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1715817600000",
    "number": "1245743889",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26847 S DIXIE HWY",
            "city": "HOMESTEAD",
            "state": "FL",
            "postal_code": "330327524",
            "telephone_number": "305-258-9352",
            "fax_number": "786-404-3604"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26847 S DIXIE HWY",
            "city": "HOMESTEAD",
            "state": "FL",
            "postal_code": "330327524",
            "telephone_number": "305-258-9352",
            "fax_number": "786-404-3604"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VIDA MEDICAL GROUP PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-11-06",
        "last_updated": "2024-05-16",
        "certification_date": "2024-05-16",
        "status": "A",
        "authorized_official_last_name": "MARQUEZ",
        "authorized_official_first_name": "DAGOBERTO",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "786-586-7645",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "APRN11013592"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ria Viacrucis
• Fanny Viart
• Vickis Alf
• Victoria ABA LLC
• Vida Adult Day Care Corp
• Vidacupuncture,LLC
• Laura Vielma
• Lisliany Gabriela Vielma
• Nelson Jorge Viera Villa
• Omar Viera

• Family Nurse Practitioner in Homestead, FL
• Providers in Homestead, FL by specialty
• Family Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.