Provider Demographics
NPI:1447883103
Name:VIDAMER HEALTH INC
Entity type:Organization
Organization Name:VIDAMER HEALTH INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:IVAN
Authorized Official - Middle Name:RAFAEL
Authorized Official - Last Name:VALDES ABREU
Authorized Official - Suffix:
Authorized Official - Credentials:APRN-FNP-C
Authorized Official - Phone:305-982-8913
Mailing Address - Street 1:10300 SUNSET DR STE 232
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33173-3003
Mailing Address - Country:US
Mailing Address - Phone:305-982-8913
Mailing Address - Fax:786-991-2304
Practice Address - Street 1:10300 SUNSET DR STE 232
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33173-3003
Practice Address - Country:US
Practice Address - Phone:305-982-8913
Practice Address - Fax:786-991-2304
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-20
Last Update Date:2020-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty