Provider Demographics
NPI:1669065892
Name:VDA COMMUNITY CENTER CORP
Entity type:Organization
Organization Name:VDA COMMUNITY CENTER CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:FELIX
Authorized Official - Middle Name:
Authorized Official - Last Name:BARRERA MORALES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-893-6168
Mailing Address - Street 1:14247 SW 42ND ST UNIT 15
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33175-6408
Mailing Address - Country:US
Mailing Address - Phone:786-817-2976
Mailing Address - Fax:786-431-2567
Practice Address - Street 1:14247 SW 42ND ST UNIT 15
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33175-6408
Practice Address - Country:US
Practice Address - Phone:786-817-2976
Practice Address - Fax:786-431-2567
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-18
Last Update Date:2023-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)