Organization Active NPI

Vida Healthcare Networks Corp

  • General Practice Physician
  • Cutler Bay, FL
National Provider Identifier
1760125769
Registry record updated Jul 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
Legal business name
VIDA HEALTHCARE NETWORKS CORP
Practice address
11285 SW 211TH St Ste 305
Cutler Bay, FL 33189-2213
Phone
(305) 218-9996
NPI assigned
Apr 18, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2022

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

Authorized official

Name
Roberto Rodriguez
Title
President
Phone
(305) 218-9996

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0800X
General Practice PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208D00000X Primary

Addresses

Primary practice location

11285 SW 211TH St Ste 305
Cutler Bay, FL 33189-2213

Mailing address

11285 SW 211TH St Ste 305
Cutler Bay, FL 33189-2213
Phone (305) 305-2189

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220711001343 FL Part B Supplier - Clinic/Group Practice 1557741303 Receives reassigned benefits from 4 practitioners
Practice locations: Cutler Bay, FL

National Provider Directory

National Provider Directory

Locations

11285 SW 211th St
Ste 305
Miami, FL 33189
Phone (786) 980-7496

Practitioners & affiliated clinicians

Practitioners 5

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

NPI Registry JSON

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

{
    "created_epoch": "1650240000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658707200000",
    "number": "1760125769",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11285 SW 211TH ST STE 305",
            "city": "CUTLER BAY",
            "state": "FL",
            "postal_code": "331892213",
            "telephone_number": "305-305-2189"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11285 SW 211TH ST STE 305",
            "city": "CUTLER BAY",
            "state": "FL",
            "postal_code": "331892213",
            "telephone_number": "305-218-9996"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VIDA HEALTHCARE NETWORKS CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-04-18",
        "last_updated": "2022-07-25",
        "certification_date": "2022-07-25",
        "status": "A",
        "authorized_official_last_name": "RODRIGUEZ",
        "authorized_official_first_name": "ROBERTO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "305-218-9996"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cutler Bay, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 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.