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VIDA MEDICAL CLINIC LLC
NPI 1356967475
General Practice in Kissimmee, FL

Active since June 24, 2020CLIA Certified · 2 labs
1960 E OSCEOLA PKWY, KISSIMMEE, FL 34743(407) 978-6400(407) 530-4326 Get Directions Write a Review

NPPES record last updated: May 2, 2023. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: May 2, 2023, Apr 23, 2021, Jun 24, 2020 (3 updates tracked since 2020).

About Vida Medical Clinic Llc NPPES

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

VIDA MEDICAL CLINIC LLC (NPI 1356967475) is a healthcare organization registered as a general practice in Kissimmee, Florida and active in the NPI registry since June 2020. The organization holds 2 active CLIA laboratory certificates, maintains a secondary practice location in Orlando, and lists Karem M Feeley, Administrator, as its authorized official.

NPPES Registry Identity

NPI1356967475
Entity TypeOrganization
Primary Taxonomy208D00000X
Legal Business NameVIDA MEDICAL CLINIC LLC
Location Address1960 E OSCEOLA PKWYKissimmee, FL 34743-8626
Mailing Address7550 Futures Dr Ste 104Orlando, FL 32819-9096 · (407) 978-6400 · Fax (407) 530-4502
Phone(407) 978-6400
Fax(407) 530-4326
Organization SubpartNo
Authorized OfficialKarem M FeeleyAdministrator · (407) 978-6400
Enumeration DateJune 24, 2020
Last NPPES UpdateMay 2, 20233 updates tracked since enumeration
NPPES CertifiedMarch 21, 2023
✔ NPI 1356967475 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyGeneral PracticeAllopathic & Osteopathic Physicians
Taxonomy Code208D00000X
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

1960 E OSCEOLA PKWY, Kissimmee, FL 34743
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Secondary Practice Location 1

Location 17550 Futures Dr Ste 104Orlando, FL 32819-9096 · Phone (407) 978-6400 · Fax (407) 530-4502

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA 2

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 10D2235271

Vida Medical Clinic LLC · Orlando, FL
Active · expires Sep 7, 2027
CLIA Number10D2235271
Laboratory TypePhysician Office
Certificate Effective DateSeptember 8, 2025
Certificate Expiration DateSeptember 7, 2027
Laboratory DirectorCarlos J. Lugo
Laboratory Phone(407) 978-6400
Laboratory LocationVida Medical Clinic LLC7550 Futures Drive Suite 104, Orlando, FL 32819
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 10D2195301

Vida Medical Clinic LLC · Kissimmee, FL
Active · expires Oct 6, 2026
CLIA Number10D2195301
Laboratory TypePhysician Office
Certificate Effective DateOctober 7, 2024
Certificate Expiration DateOctober 6, 2026
Laboratory DirectorCarlos Lugo-Vazquez
Laboratory Phone(407) 978-6400
Laboratory LocationVida Medical Clinic LLC1960 E Osceola Parkway, Kissimmee, FL 34743
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. CARLOS JAVIER LUGO MD
General Practice
1960 E OSCEOLA PKWY
KISSIMMEE, FL 34743
Osceola County (407) 978-6400

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 Vida Medical Clinic LLC's NPI number?

The NPI number for Vida Medical Clinic LLC is 1356967475. It was assigned to this organization in the NPPES registry on June 24, 2020.

Where is Vida Medical Clinic LLC located?

Vida Medical Clinic LLC is located at 1960 E Osceola Pkwy, Kissimmee, FL 34743. The listed phone number is (407) 978-6400.

What is Vida Medical Clinic LLC's specialty?

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

Does Vida Medical Clinic LLC hold CLIA laboratory certificates?

Yes. 2 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.

When was this NPI record last updated?

The NPPES record for Vida Medical Clinic LLC was last updated on May 2, 2023. NPI Profile syncs with the weekly NPPES data releases published by CMS.