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NPI Code Detail

MEDICARE: VIGOR HEALTH PLUS II, LLC

MEDICARE: VIGOR HEALTH PLUS II, LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1251S00000XCommunity/Behavioral Health Agency

General Provider Information

NPI Number : 1205462041
Entity Type Code : Organization
Provider Name (Legal Business Name) : VIGOR HEALTH PLUS II, LLC
Provider Business Mailing Address
First Line : 3505 LAKE LYNDA DRIVE BLDG 300
Second Line : STE 200
City : ORLANDO
State : FL
Zip : 32817-8333
Country : US
Telephone Number : 754-581-4808
Fax Number :
Provider Business Practice Location Address
First Line : 3505 LAKE LYNDA DRIVE BLDG 300
Second Line : STE 200
City : ORLANDO
State : FL
Zip : 32817-8333
Country : US
Telephone Number : 754-581-4808
Fax Number :
Authorized Official
Title or Position : OWNER/MANAGER
Name : MALISHA MCPHAUL
Credential :
Telephone Number : 754-581-4808
Provider Enumeration Date : 03/12/2020
Last Update Date : 03/12/2020

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Directions to “VIGOR HEALTH PLUS II, LLC ” Practice Location

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