Provider Demographics
NPI:1487032165
Name:ACVA MEDICAL GROUP
Entity Type:Organization
Organization Name:ACVA MEDICAL GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ARNALDO
Authorized Official - Middle Name:
Authorized Official - Last Name:VALIDO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-873-4766
Mailing Address - Street 1:6850 CORAL WAY STE 304
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33155-1758
Mailing Address - Country:US
Mailing Address - Phone:305-873-4766
Mailing Address - Fax:
Practice Address - Street 1:6850 CORAL WAY STE 304
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33155-1758
Practice Address - Country:US
Practice Address - Phone:305-873-4766
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-13
Last Update Date:2015-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty