Provider Demographics
NPI:1114090073
Name:AMADO VIERA, MD, PA
Entity Type:Organization
Organization Name:AMADO VIERA, MD, PA
Other - Org Name:VIERA MEDICAL GROUP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:AMADO
Authorized Official - Middle Name:
Authorized Official - Last Name:VIERA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-835-0438
Mailing Address - Street 1:777 E 25TH ST
Mailing Address - Street 2:STE 118
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33013-3825
Mailing Address - Country:US
Mailing Address - Phone:305-835-0438
Mailing Address - Fax:305-693-0768
Practice Address - Street 1:777 E 25TH ST
Practice Address - Street 2:STE 118
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33013-3825
Practice Address - Country:US
Practice Address - Phone:305-835-0438
Practice Address - Fax:305-693-0768
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-16
Last Update Date:2009-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL273055300Medicaid
FLU5333ZMedicare PIN