VIDA MEDICAL CLINIC LLC – General Practice Physician, NPI 1356967475
General Practice Physician
Main info
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for VIDA MEDICAL CLINIC LLC
7550 FUTURES DR STE 104
ORLANDO, FL 328199096
Phone: (407) 978-6400
Fax: (407) 530-4502
Type: Mailing
8297 CHAMPIONS GATE BLVD # 125
CHAMPIONS GATE, FL 338968387
Phone: (787) 922-7013
Type: Mailing
1952 E OSCEOLA PKWY
KISSIMMEE, FL 347438626
Phone: (407) 978-6400
Type: Location
1960 E OSCEOLA PKWY
KISSIMMEE, FL 347438626
Phone: (407) 978-6400
Fax: (407) 530-4326
Type: Location
7550 Futures Dr Ste 104
Orlando, FL 328199096
Phone: (407) 978-6400
Fax: (407) 530-4502
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2020-09-23
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Revalidation due soon
Earliest CMS due date is 2026-07-31 (47 days away).
Enrollment records
1
Earliest due date
2026-07-31
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| O20200923000039 | O | Clinic/Group Practice | FL | 2026-07-31 |
What to do next
- Confirm the due date on the CMS Revalidation Lookup Tool.
- Complete revalidation in PECOS before the published due date.
- If you have multiple enrollment records, revalidate each one on its own schedule.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 32819)
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