Provider Demographics
NPI:1891532008
Name:VIDA HEALTHCARE SERVICES INC
Entity type:Organization
Organization Name:VIDA HEALTHCARE SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER 11014696
Authorized Official - Prefix:
Authorized Official - First Name:PASCUAL
Authorized Official - Middle Name:
Authorized Official - Last Name:MORA DELGADO
Authorized Official - Suffix:
Authorized Official - Credentials:APRN 11014696
Authorized Official - Phone:786-486-9896
Mailing Address - Street 1:2387 W 68TH ST STE 201
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33016-6890
Mailing Address - Country:US
Mailing Address - Phone:305-557-8486
Mailing Address - Fax:305-557-1025
Practice Address - Street 1:2387 W 68TH ST STE 201
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33016-6890
Practice Address - Country:US
Practice Address - Phone:305-557-8486
Practice Address - Fax:305-557-1025
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-15
Last Update Date:2025-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty