Provider Demographics
NPI:1316573850
Name:IMHOTEPCX INC
Entity Type:Organization
Organization Name:IMHOTEPCX INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/ PSYCHIATRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:VLADIMIR
Authorized Official - Middle Name:ALEJANDRO
Authorized Official - Last Name:GUEVARA VAZQUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:786-538-8989
Mailing Address - Street 1:7101 SW 21ST ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33155-1622
Mailing Address - Country:US
Mailing Address - Phone:786-538-8989
Mailing Address - Fax:
Practice Address - Street 1:1201 N 37TH AVE
Practice Address - Street 2:
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33021-5414
Practice Address - Country:US
Practice Address - Phone:754-777-5600
Practice Address - Fax:510-281-1437
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-17
Last Update Date:2023-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty