Provider Demographics
NPI:1649599325
Name:WALKER, VIVIAN MICHAEL (MS)
Entity Type:Individual
Prefix:MR
First Name:VIVIAN
Middle Name:MICHAEL
Last Name:WALKER
Suffix:
Gender:M
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2240 SW 67TH WAY
Mailing Address - Street 2:
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33023-2765
Mailing Address - Country:US
Mailing Address - Phone:954-963-0783
Mailing Address - Fax:
Practice Address - Street 1:20201 NW 37TH AVE
Practice Address - Street 2:
Practice Address - City:MIAMI GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33056-1755
Practice Address - Country:US
Practice Address - Phone:786-466-2700
Practice Address - Fax:786-466-2648
Is Sole Proprietor?:No
Enumeration Date:2010-05-20
Last Update Date:2010-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker