Provider Demographics
NPI:1992194567
Name:ORIZU, VIVIAN OBIAGERI (MPH)
Entity Type:Individual
Prefix:MS
First Name:VIVIAN
Middle Name:OBIAGERI
Last Name:ORIZU
Suffix:
Gender:F
Credentials:MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:160 NW 176TH ST
Mailing Address - Street 2:STE 302-3
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33169
Mailing Address - Country:US
Mailing Address - Phone:305-305-3545
Mailing Address - Fax:
Practice Address - Street 1:160 NW 176TH ST
Practice Address - Street 2:STE 302-3
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33169-5021
Practice Address - Country:US
Practice Address - Phone:305-305-3545
Practice Address - Fax:954-435-2363
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-20
Last Update Date:2015-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL251C00000X, 374U00000X, 376J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
No374U00000XNursing Service Related ProvidersHome Health Aide
No376J00000XNursing Service Related ProvidersHomemaker
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL003410000Medicaid
FL003239100Medicaid