Provider Demographics
NPI:1659318566
Name:V AND R MEDICAL GROUP INC
Entity Type:Organization
Organization Name:V AND R MEDICAL GROUP INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:ROLANDO
Authorized Official - Middle Name:
Authorized Official - Last Name:CHIRINO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-319-0706
Mailing Address - Street 1:700 E 1ST AVE
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33010-4406
Mailing Address - Country:US
Mailing Address - Phone:305-883-1060
Mailing Address - Fax:305-883-8624
Practice Address - Street 1:700 E 1ST AVE
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33010-4406
Practice Address - Country:US
Practice Address - Phone:305-883-1060
Practice Address - Fax:305-883-8624
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-31
Last Update Date:2014-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLHCC6385261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLK8394Medicare PIN