CHARLIE VIDAL (NPI# 1114416708) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114416708 |
| Entity Type | Individual |
| Full Name | CHARLIE VIDAL |
| Credential | MD, MPH, MBA |
| Practice Address |
Carr 5523 Km 4.4 Bo Arenas Utuado PR 00641 |
| Mailing Address |
Hc 4 Box 10578 Utuado PR 00641-7518 |
| Practice Telephone | 7872429604 |
| Enumeration Date | 2018-05-09 |
| Last Update Date | 2018-05-09 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP0904X |
Clinic/Center Specialization: Public Health, Federal |
PR | Ambulatory Health Care Facilities | |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | PR | Student, Health Care | |
| N | 174H00000X | Health Educator | Other Service Providers |
| Street Address |
CARR 5523 KM 4.4 BO ARENAS |
| City | UTUADO |
| State | PR |
| Zip Code | 00641 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598364382 | Rosa Walkiria Rivera | Social Worker | Vivi Abajo Sector La Mula Km .1, Utuado, PR 00641 | 2020-10-22 |
| 1104430883 | Laboratorio Clinico Otoao LLC | Clinical Medical Laboratory | Carretera # 111, Km. 2.9, Vivi Abajo, Utuado, PR 00641 | 2020-09-01 |
| 1265067029 | Veronica Cristina Ortiz | Social Worker | Calle Isaac Gonzalez Martinez, Utuado, PR 00641 | 2020-03-11 |
| 1003453069 | Krystal Lee Perez-martinez | Social Worker | 2600 Calle Ledesma, Utuado, PR 00641 | 2019-12-09 |
| 1477199024 | Corp De Servicios De Salud Y Desarrollo Socioeconomico Del Otoa | Ambulance | Barrio Mameyes Carr 140 Km 28.3, Utuado, PR 00641 | 2019-11-19 |
| 1285285684 | Daismar Amador | Social Worker | Calle Antonio R. Barcelo #5, Utuado, PR 00641 | 2019-09-26 |
| 1477106870 | Jose Omar Serrano Rosa | Registered Nurse | Urb. Jesus M. Lago M-30, Utuado, PR 00641 | 2019-07-24 |
| 1639733553 | Ashley Marie Gonzalez Lopez | General Practice | Hospital Metropolitano De La Montana, Calle Isaac Gonzalez Martinez Esq Ledesma, Utuado, PR 00641 | 2019-04-25 |
| 1962970798 | Centro De Salud Familiar San Miguel Arcangel Inc | General Practice | Calle San Miguel #2, Utuado, PR 00641 | 2018-11-09 |
| 1487130357 | Rafael Alejandro Del Valle Diaz | General Practice | 17 Calle Dr Cueto, Utuado, PR 00641 | 2018-07-13 |
| Find all providers in zip 00641 | ||||
| Taxonomy Code | 261QP0904X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Public Health, Federal |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043675622 | Centro De Medicina Integral De Manati,inc | Clinic/Center | 77 Bo Cotto, Urbanizacion Felix Cordova Davila, Manati, PR 00674-0000 | 2015-12-23 |
| 1720174014 | Centro De Medicina Integral De Manati Inc | Clinic/Center | Bo. Cotto #77 Urbanizacion Felix Cordova Davila, Manati, PR 00674 | 2006-10-05 |
Please comment or provide details below to improve the information on CHARLIE VIDAL.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.