Vidaltia Corp.

LBN: Vidaltia Corp.
Vidaltia Corp. is an health care organization with primary practice located at 6456 Nw 5Th Way , Fort Lauderdale FL 33309-6112. The organization recently has 15 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Ambulatory Health Care Facilities / Federally Qualified Health Center (FQHC), Ambulatory Health Care Facilities / Health Service, Ambulatory Health Care Facilities / Infusion Therapy, Ambulatory Health Care Facilities / Public Health, Federal, Ambulatory Health Care Facilities / Public Health, State or Local, Ambulatory Health Care Facilities / Primary Care, Ambulatory Health Care Facilities / Pain, Ambulatory Health Care Facilities / VA, Ambulatory Health Care Facilities / Occupational Medicine, Hospitals / Chronic Disease Hospital, Managed Care Organizations / Exclusive Provider Organization, Managed Care Organizations / Health Maintenance Organization, Managed Care Organizations / Preferred Provider Organization, Managed Care Organizations / Point of Service. Allopathic & Osteopathic Physicians / Internal Medicine is the primary health care specialty. Vidaltia Corp. can be contacted via phone (202) 802-0082, or through Fenelon, Ezechiel via phone (202) 802-0082.

Contact Information

Primary practice address
6456 Nw 5Th Way Fort Lauderdale FL 33309-6112
Phone: (202) 802-0082
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Fenelon, Ezechiel
Phone: (202) 802-0082

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X
Ambulatory Health Care Facilities / Federally Qualified Health Center (FQHC) 261QF0400X
Ambulatory Health Care Facilities / Health Service 261QH0100X
Ambulatory Health Care Facilities / Infusion Therapy 261QI0500X
Ambulatory Health Care Facilities / Public Health, Federal 261QP0904X
Ambulatory Health Care Facilities / Public Health, State or Local 261QP0905X
Ambulatory Health Care Facilities / Primary Care 261QP2300X
Ambulatory Health Care Facilities / Pain 261QP3300X
Ambulatory Health Care Facilities / VA 261QV0200X
Ambulatory Health Care Facilities / Occupational Medicine 261QX0100X
Hospitals / Chronic Disease Hospital 281P00000X
Managed Care Organizations / Exclusive Provider Organization 302F00000X
Managed Care Organizations / Health Maintenance Organization 302R00000X
Managed Care Organizations / Preferred Provider Organization 305R00000X
Managed Care Organizations / Point of Service 305S00000X

Profile Details

NPI number 1336008036
LBN Legal business name Vidaltia Corp.
DBA Doing business as
Authorized official Fenelon, Ezechiel
Entity Organization
Organization subpart 1 No
Enumeration date Jan 19th, 2026
Last updated May 26th, 2026 - about 5 months ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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