Healthcare Provider Details

I. General information

NPI: 1942003942
Provider Name (Legal Business Name): VITALICARE WELLNESS CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/27/2025
Last Update Date: 10/18/2025
Certification Date: 10/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10700 CARIBBEAN BLVD STE 402
CUTLER BAY FL
33189-1232
US

IV. Provider business mailing address

10700 CARIBBEAN BLVD STE 402
CUTLER BAY FL
33189-1232
US

V. Phone/Fax

Practice location:
  • Phone: 786-548-6774
  • Fax:
Mailing address:
  • Phone: 786-548-6774
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ROBERTO RASUA VELOSO
Title or Position: PRESIDENT
Credential:
Phone: 786-805-2642