Healthcare Provider Details

I. General information

NPI: 1518906940
Provider Name (Legal Business Name): VIRTUOX, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/04/2006
Last Update Date: 05/19/2025
Certification Date: 05/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5850 CORAL RIDGE DR SUITE 304
CORAL SPRINGS FL
33076-3378
US

IV. Provider business mailing address

5850 CORAL RIDGE DR SUITE 304
CORAL SPRINGS FL
33076-3378
US

V. Phone/Fax

Practice location:
  • Phone: 877-337-7111
  • Fax: 877-243-2589
Mailing address:
  • Phone: 877-337-7111
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License NumberHCC6903
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License NumberHCC6903
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code261QS1200X
TaxonomySleep Disorder Diagnostic Clinic/Center
License Number
License Number StateCA
# 4
Primary TaxonomyN
Taxonomy Code261QS1200X
TaxonomySleep Disorder Diagnostic Clinic/Center
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code293D00000X
TaxonomyPhysiological Laboratory
License Number
License Number State
# 6
Primary TaxonomyY
Taxonomy Code293D00000X
TaxonomyPhysiological Laboratory
License Number
License Number StateDC

VIII. Authorized Official

Name: STEVEN LICA
Title or Position: GENERAL MANAGER
Credential:
Phone: 954-866-1788