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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

CHARLIE VIDAL, MD, MPH, MBA

Deactivated Sole Proprietor

CHARLIE VIDAL, MD, MPH, MBA is a General Practice healthcare provider located in SAN JUAN, Puerto Rico. NPI 1114416708 is deactivated in the NPPES registry. Verify at CMS.

General Practice · SAN JUAN, PR

This NPI has been deactivated. The record was deactivated on April 18, 2022. Deactivated NPIs are no longer valid for billing or credentialing. The provider may have retired, changed practice status, or had their NPI administratively deactivated. Verify current licensure status with the NPPES NPI Registry or the relevant state medical board before relying on this record.

Registration Details

NPI Number
1114416708
Provider Type
Individual
Gender
Male
NPI Issued
May 9, 2018 (3.9424657534247 yrs)
Last Updated
Mar 15, 2023
Deactivated
Apr 18, 2022
License
16158-I (PR)
Sole Proprietor
Yes

Practice Information

Address
123 ST IN PUERTO RICO
SAN JUAN, PR, 00918
Browse PR providers · Browse ZIP 00918
Phone
7872420101
Primary Specialty
General Practice
208D00000X

Other General Practice Providers in SAN JUAN, PR

Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.