Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Juan D Vidal, PA-C

Individual provider Physician Assistant · NPI 1922384098

Juan D Vidal, PA-C is a Physician Assistant in Pembroke Pines, Florida. Qualified in 2011, 15 years ago. Practices with Conviva Medical Center Management, LLC, a 562-clinician group, works from 2 locations, accepts Medicare assignment and offers telehealth. Licensed in Florida.

Years since qualifying
15
Licensed in
FL
In the registry since
2011
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

11460 Pines Blvd
Pembroke Pines, FL 33026-4128
Phone: (954) 433-4200
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 1316 N State Road 7, Margate, FL 33063-2843 — (954) 968-9993

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence PA9106281 (FL)

Record details

NPI number1922384098
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorNo
NPI enumeratedNovember 2, 2011
Last updated in NPPESMarch 3, 2026
Certification dateMarch 3, 2026

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2011 (15 years in practice)
Group practice Conviva Medical Center Management, Llc — 562 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations2 on file with Medicare

Other providers in Pembroke Pines