CHARLIE VIDAL MD, MPH, MBA
NPI 1114416708
General Practice in San Juan, PR

Q: What is Charlie Vidal's NPI number?

The NPI number for Charlie Vidal is 1114416708. It was assigned to this individual provider in the NPPES registry on May 9, 2018.

Q: What is Charlie Vidal's specialty?

The primary specialty registered for this NPI is General Practice with taxonomy code 208D00000X.

Q: When was this NPI record last updated?

The NPPES record for Charlie Vidal was last updated on March 15, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since May 09, 2018PECOS Enrolled

123 ST IN PUERTO RICO, SAN JUAN, PR 00918(787) 242-0101 Get Directions Write a Review

NPPES record last updated: March 15, 2023. Verified against the NPPES registry weekly; last sync: September 27, 2026.

Record update history: Sep 14, 2026, Mar 15, 2023, Dec 15, 2022 and 1 more (4 updates tracked since 2018).

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About Charlie Vidal Md, Mph, Mba NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CHARLIE VIDAL MD, MPH, MBA (NPI 1114416708) is an individual general practice provider in San Juan, Puerto Rico, licensed in Puerto Rico (16158-I) and active in the NPI registry since May 2018. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1114416708

Entity TypeIndividualMale

Primary Taxonomy208D00000X

Provider Legal NameCHARLIE VIDALCredential: MD, MPH, MBA

Location Address123 ST IN PUERTO RICOSan Juan, PR 00918

Mailing Address123 St In Puerto RicoSan Juan, PR 00918

Phone(787) 242-0101

Sole ProprietorYes

Enumeration DateMay 9, 2018

Last NPPES UpdateMarch 15, 20234 updates tracked since enumeration

NPPES CertifiedMarch 14, 2023

✔ NPI 1114416708 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyGeneral PracticeAllopathic & Osteopathic Physicians

Taxonomy Code208D00000X

License✔ Licensed in PR · 16158-I

Definition

A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Charlie Vidal Md, Mph, Mba is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer– Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Charlie Vidal's NPI number?

The NPI number for Charlie Vidal is 1114416708. It was assigned to this individual provider in the NPPES registry on May 9, 2018.

Where is Charlie Vidal located?

Charlie Vidal practices at 123 St In Puerto Rico, San Juan, PR 00918. The listed phone number is (787) 242-0101.

What is Charlie Vidal's specialty?

The primary specialty registered for this NPI is General Practice with taxonomy code 208D00000X.

Is Charlie Vidal enrolled in Medicare?

Yes. Charlie Vidal is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Charlie Vidal was last updated on March 15, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.