Provider Demographics
NPI:1871967307
Name:RAFAEL OLIVER-VIDAUD
Entity type:Organization
Organization Name:RAFAEL OLIVER-VIDAUD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD ANESTHESIOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:RAFAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:OLIVER-VIDAUD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-383-1782
Mailing Address - Street 1:PO BOX 551506
Mailing Address - Street 2:
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33355-1506
Mailing Address - Country:US
Mailing Address - Phone:954-382-1782
Mailing Address - Fax:954-382-1989
Practice Address - Street 1:3070 SW 121ST AVE
Practice Address - Street 2:
Practice Address - City:DAVIE
Practice Address - State:FL
Practice Address - Zip Code:33330-1318
Practice Address - Country:US
Practice Address - Phone:954-383-1782
Practice Address - Fax:954-382-1989
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-11-20
Last Update Date:2015-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty