Provider Demographics
NPI:1649028572
Name:VIP INTEGRAL CLINIC INC
Entity type:Organization
Organization Name:VIP INTEGRAL CLINIC INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LOIPA
Authorized Official - Middle Name:
Authorized Official - Last Name:HERNANDEZ ARENCIBIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-546-8454
Mailing Address - Street 1:8040 NW 95TH ST STE 224
Mailing Address - Street 2:
Mailing Address - City:HIALEAH GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33016-2361
Mailing Address - Country:US
Mailing Address - Phone:305-546-8454
Mailing Address - Fax:
Practice Address - Street 1:8040 NW 95TH ST STE 224
Practice Address - Street 2:
Practice Address - City:HIALEAH GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33016-2361
Practice Address - Country:US
Practice Address - Phone:305-546-8454
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-07
Last Update Date:2024-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center