Provider Demographics
NPI:1811575087
Name:VIVA MEDICAL CENTER
Entity Type:Organization
Organization Name:VIVA MEDICAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:YISSEL
Authorized Official - Middle Name:
Authorized Official - Last Name:PEREZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-209-0002
Mailing Address - Street 1:10560 NW 27TH ST UNIT G101-A
Mailing Address - Street 2:
Mailing Address - City:DORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33172-5928
Mailing Address - Country:US
Mailing Address - Phone:305-209-0001
Mailing Address - Fax:
Practice Address - Street 1:10560 NW 27TH ST UNIT G101-A
Practice Address - Street 2:
Practice Address - City:DORAL
Practice Address - State:FL
Practice Address - Zip Code:33172-5928
Practice Address - Country:US
Practice Address - Phone:305-209-0001
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-30
Last Update Date:2021-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center