Provider Demographics
NPI:1235953845
Name:VILIV HEALTH
Entity type:Organization
Organization Name:VILIV HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RICARDO
Authorized Official - Middle Name:ANTONIO
Authorized Official - Last Name:IVONNET GALBAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-539-6221
Mailing Address - Street 1:12934 SW 285TH TER
Mailing Address - Street 2:
Mailing Address - City:HOMESTEAD
Mailing Address - State:FL
Mailing Address - Zip Code:33033-1997
Mailing Address - Country:US
Mailing Address - Phone:786-539-6221
Mailing Address - Fax:
Practice Address - Street 1:900 SW 97TH AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33174-2935
Practice Address - Country:US
Practice Address - Phone:786-507-5530
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-11
Last Update Date:2025-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care