| Organization Name: | VIDAL MEDICAL OFFICE PLC |
| NPI Number: | 1023112760 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | HILDA FLORES-VIDAL (OWNER) |
| Mailing Address: | 21300 N John Wayne Pkwy Unit 116 Bldg 7 Maricopa |
| State: | AZ US |
| Postal Code: | 851398979 |
| Phone Number: | 5204239699 |
| Fax Number: | 5204239599 |
| NPI Enumeration Date: | 09/12/2006 |
| NPI Last Update Date: | 01/25/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 207QA0505X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Family Medicine |
| Taxonomy Specialization: | Adult Medicine |
| Taxonomy Definition: | |