Provider Demographics
NPI:1043027840
Name:VIDA WOMENS HEALTH PLLC
Entity type:Organization
Organization Name:VIDA WOMENS HEALTH PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OBGYN, CEO/CMO
Authorized Official - Prefix:DR
Authorized Official - First Name:ALDO
Authorized Official - Middle Name:RAFAEL
Authorized Official - Last Name:NUNEZ HRUSKA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:313-938-6687
Mailing Address - Street 1:16555 E JEFFERSON AVE
Mailing Address - Street 2:
Mailing Address - City:GROSSE POINTE PARK
Mailing Address - State:MI
Mailing Address - Zip Code:48230-1428
Mailing Address - Country:US
Mailing Address - Phone:313-938-6687
Mailing Address - Fax:
Practice Address - Street 1:16555 E JEFFERSON AVE
Practice Address - Street 2:
Practice Address - City:GROSSE POINTE PARK
Practice Address - State:MI
Practice Address - Zip Code:48230-1428
Practice Address - Country:US
Practice Address - Phone:313-938-6687
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-16
Last Update Date:2024-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty