Provider Demographics
NPI:1952651044
Name:VIVAS, SIGIFREDO (MD)
Entity Type:Individual
Prefix:DR
First Name:SIGIFREDO
Middle Name:
Last Name:VIVAS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9226 BAYWAY DR
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32819-4082
Mailing Address - Country:US
Mailing Address - Phone:904-607-1460
Mailing Address - Fax:
Practice Address - Street 1:9226 BAYWAY DR
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32819-4082
Practice Address - Country:US
Practice Address - Phone:904-607-1460
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-15
Last Update Date:2012-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME41382207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine