Carolyn George MD, PA/Vida Integrative Medicine

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

CAROLYN GEORGE MD, PA/VIDA INTEGRATIVE MEDICINE

Practice address

12651 W Sunrise Blvd Ste 103
Sunrise, FL 33323-0906

Phone

(954) 361-5202

Fax

(954) 448-7741

NPI assigned

Sep 6, 2019

Organization subpart

No

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

Authorized official

Name

Dr. Carolyn S George, MDNPI 1740447051

Title

President

Phone

(954) 361-5202

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• VIDA Integrative Medicine Doing business as

Locations

Practitioners 1

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

• Carolyn Sue George, MD

  • General Practice Physician
  • Sunrise, FL
  • NPI 1740447051
  NPD Authorized official

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

{
    "created_epoch": "1567728000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1567728000000",
    "number": "1962051458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2969 WENTWORTH",
            "city": "WESTON",
            "state": "FL",
            "postal_code": "333321841",
            "telephone_number": "954-288-2789"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12651 W SUNRISE BLVD STE 103",
            "city": "SUNRISE",
            "state": "FL",
            "postal_code": "333230906",
            "telephone_number": "954-361-5202",
            "fax_number": "954-448-7741"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAROLYN GEORGE MD, PA/VIDA INTEGRATIVE MEDICINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-09-06",
        "last_updated": "2019-09-06",
        "status": "A",
        "authorized_official_last_name": "GEORGE",
        "authorized_official_first_name": "CAROLYN",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "954-361-5202",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1740447051",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "VIDA Integrative Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Vincenza Tina Carini, LCMHC
• Carlos a. Pozo
• Sara Carlson, RN
• Christina Carmona, ARNP
• Sharlene Ann Carneiro
• Scott J. Carpenter, CRNA
• Edisnel Carrazana Garces, DDS
• Rey Anthony Cartajenas Carreon
• Mariana Valentina Cartaya
• Jasmine Carter

• Primary Care Clinic/Center in Sunrise, FL
• Providers in Sunrise, FL by specialty
• Primary Care Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.