Healthcare Provider Details

I. General information

NPI: 1750368007
Provider Name (Legal Business Name): MEDICAL TECHNOLOGIES UNLIMITED INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/28/2005
Last Update Date: 07/30/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4000 PONCE DE LEON SUITE 470
CORAL GABLES FL
33146
US

IV. Provider business mailing address

P.O. BOX 56-6207
MIAMI FL
33256
US

V. Phone/Fax

Practice location:
  • Phone: 305-595-7177
  • Fax:
Mailing address:
  • Phone: 305-595-7177
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License NumberME0038819
License Number StateFL

VIII. Authorized Official

Name: MR. MARCO N. VITIELLO
Title or Position: PRESIDENT
Credential: MD
Phone: 305-595-7177