| Vidal Medical Office Plc | |
|
21300 N John Wayne Pkwy Unit 116 Bldg 7 Maricopa AZ 85139-8979 | |
| (520) 423-9699 | |
| (520) 423-9599 |
| Full Name | Vidal Medical Office Plc |
|---|---|
| Speciality | Family Medicine |
| Location | 21300 N John Wayne Pkwy, Maricopa, Arizona |
| Authorized Official Name and Position | Hilda Flores-vidal (OWNER) |
| Authorized Official Contact | 5204239699 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Vidal Medical Office Plc 21300 N John Wayne Pkwy Unit 116 Bldg 7 Maricopa AZ 85139-8978 Ph: (520) 423-9699 | Vidal Medical Office Plc 21300 N John Wayne Pkwy Unit 116 Bldg 7 Maricopa AZ 85139-8979 Ph: (520) 423-9699 |
| NPI Number | 1023112760 |
|---|---|
| Provider Enumeration Date | 09/12/2006 |
| Last Update Date | 04/03/2017 |
| Medicare PECOS PAC ID | 0941214027 |
|---|---|
| Medicare Enrollment ID | O20060127000263 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023112760 | NPI | - | NPPES |
| 313021 | Other | AZ | AHCCCS # |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207QA0505X | Family Medicine - Adult Medicine | (* (Not Available)) | Primary |
| Provider Name | Hilda M Flores Vidal |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1376646810 PECOS PAC ID: 9234024456 Enrollment ID: I20040217000909 |
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