Victoria Medical Group Inc

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

VICTORIA MEDICAL GROUP INC

Practice address

5801 NW 151St St Ste 203
Miami Lakes, FL 33014-2437

Phone

(305) 822-4447

Fax

(305) 822-4484

NPI assigned

Oct 18, 2006

Last updated

Jan 3, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Altagracia Adalgiza Victoria, MDNPI 1649220898

Title

President

Phone

(305) 822-4447

Specialties & licenses 2

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Altagracia Adalgiza Victoria, M.D.

  • Family Medicine Physician
  • Miami Lakes, FL
  • NPI 1649220898
  Medicare reassignment Care Compare group NPD Authorized official
• Lisbet Rodriguez Boloix, ARNP

  • Family Nurse Practitioner
  • Miramar, FL
  • NPI 1881188365

  Single Specialty

  Medicare reassignment Care Compare group NPD
• Jose Luis Lora, ARNP

  • Family Nurse Practitioner
  • Hialeah, FL
  • NPI 1447764824
  Medicare reassignment Care Compare group
• Cecilia Cristina Roman, BCBA, FNP, PMHNP-BC

  • Behavior Analyst
  • Miami, FL
  • NPI 1801340989
  Medicare reassignment NPD
• Maricela Dianexi Fardales, PA

  • Medical Physician Assistant
  • Hialeah, FL
  • NPI 1457362410
  Medicare reassignment

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

{
    "created_epoch": "1161129600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1641168000000",
    "number": "1346321734",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5801 NW 151ST ST STE 203",
            "city": "MIAMI LAKES",
            "state": "FL",
            "postal_code": "330142437",
            "telephone_number": "305-822-4447",
            "fax_number": "305-822-4484"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5801 NW 151ST ST STE 203",
            "city": "MIAMI LAKES",
            "state": "FL",
            "postal_code": "330142437",
            "telephone_number": "305-822-4447",
            "fax_number": "305-822-4484"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VICTORIA MEDICAL GROUP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-18",
        "last_updated": "2022-01-03",
        "certification_date": "2021-10-25",
        "status": "A",
        "authorized_official_last_name": "VICTORIA",
        "authorized_official_first_name": "ALTAGRACIA",
        "authorized_official_middle_name": "ADALGIZA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "305-822-4447",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "FL",
            "license": "ME-0070097",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "ME-0070097",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "EHR",
            "affiliation": "N",
            "address_1": "5801 NW 151st St Ste 203",
            "city": "Miami Lakes",
            "state": "FL",
            "country_code": "US",
            "postal_code": "330142437",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Ana Maria Viamonte Ros, MD
• Monica Viamontes Rodriguez
• Jose D Viana
• Vibrantsteps Therapy Inc
• Vibrantsteps Therapy Inc
• Altagracia Adalgiza Victoria, M.D.
• Vida Home Health Services LLC
• Vida Med Center LLC
• Vida Mental Health Services Inc
• Marieta Vidal, PHARMD

• Internal Medicine Physician in Miami Lakes, FL
• Providers in Miami Lakes, FL by specialty
• Internal Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.