Provider Demographics
NPI:1689031288
Name:VIVA HEALTH LLC
Entity Type:Organization
Organization Name:VIVA HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JUAN
Authorized Official - Middle Name:MANUEL
Authorized Official - Last Name:GARCES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-444-1244
Mailing Address - Street 1:351 NW 42ND AVE
Mailing Address - Street 2:SUITE # 503
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33126-5683
Mailing Address - Country:US
Mailing Address - Phone:305-444-1244
Mailing Address - Fax:
Practice Address - Street 1:351 NW 42ND AVE
Practice Address - Street 2:SUITE 503
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33126-5683
Practice Address - Country:US
Practice Address - Phone:305-444-1244
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-27
Last Update Date:2016-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME45734261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
1619973807OtherNATIONAL PROVIDER IDENTIFIER
FLD64025Medicare UPIN