Provider Demographics
NPI:1740401199
Name:MVDR, INC
Entity Type:Organization
Organization Name:MVDR, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MANUEL
Authorized Official - Middle Name:
Authorized Official - Last Name:FERNANDEZ-VILLADEREY
Authorized Official - Suffix:
Authorized Official - Credentials:CRT
Authorized Official - Phone:786-507-3846
Mailing Address - Street 1:42 NW 27TH AVE
Mailing Address - Street 2:SUITE 309-2
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33125-5127
Mailing Address - Country:US
Mailing Address - Phone:786-507-3846
Mailing Address - Fax:305-403-2347
Practice Address - Street 1:42 NW 27TH AVE
Practice Address - Street 2:SUITE 309-2
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33125-5127
Practice Address - Country:US
Practice Address - Phone:786-507-3846
Practice Address - Fax:305-403-2347
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPENDING227800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes227800000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, CertifiedGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLPENDINGOtherCRT SERVICE PROVIDER