Provider Demographics
NPI:1790108009
Name:IVAN RAPADO VIERA MD PA
Entity Type:Organization
Organization Name:IVAN RAPADO VIERA MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:IVAN
Authorized Official - Middle Name:
Authorized Official - Last Name:RAPADO VIERA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-776-3209
Mailing Address - Street 1:7000 SW 62ND AVE STE 300
Mailing Address - Street 2:
Mailing Address - City:SOUTH MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33143-4719
Mailing Address - Country:US
Mailing Address - Phone:305-776-3209
Mailing Address - Fax:
Practice Address - Street 1:7000 SW 62ND AVE STE 300
Practice Address - Street 2:
Practice Address - City:SOUTH MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33143-4719
Practice Address - Country:US
Practice Address - Phone:305-776-3209
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-23
Last Update Date:2014-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLACN433208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty