Provider Demographics
NPI:1528958352
Name:LA VIE MEDICAL CENTER LLC
Entity type:Organization
Organization Name:LA VIE MEDICAL CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:IDANIA
Authorized Official - Middle Name:TERESA
Authorized Official - Last Name:GARCIA DEL SOL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:786-510-9157
Mailing Address - Street 1:18112 NW 91ST CT
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33018-6544
Mailing Address - Country:US
Mailing Address - Phone:305-914-2883
Mailing Address - Fax:305-914-6269
Practice Address - Street 1:18590 NW 67TH AVE STE 200-200A
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33015-3460
Practice Address - Country:US
Practice Address - Phone:305-914-2883
Practice Address - Fax:305-914-6269
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-07-03
Last Update Date:2025-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QR1100XAmbulatory Health Care FacilitiesClinic/CenterResearch