Provider Demographics
NPI:1750197091
Name:VIVAS-PICHARDO GROUP
Entity type:Organization
Organization Name:VIVAS-PICHARDO GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:
Authorized Official - Last Name:VIVAS
Authorized Official - Suffix:SR
Authorized Official - Credentials:MD
Authorized Official - Phone:772-486-5713
Mailing Address - Street 1:3730 7TH TER STE 302
Mailing Address - Street 2:
Mailing Address - City:VERO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32960-7330
Mailing Address - Country:US
Mailing Address - Phone:772-773-6531
Mailing Address - Fax:772-539-4115
Practice Address - Street 1:3730 7TH TER STE 302
Practice Address - Street 2:
Practice Address - City:VERO BEACH
Practice Address - State:FL
Practice Address - Zip Code:32960-7330
Practice Address - Country:US
Practice Address - Phone:772-773-6531
Practice Address - Fax:772-539-4115
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-10
Last Update Date:2024-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty