Healthcare Provider Details

I. General information

NPI: 1306761036
Provider Name (Legal Business Name): HC VITALITEY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/11/2026
Last Update Date: 08/13/2026
Certification Date: 08/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2500 NW 79TH AVE STE 252
DORAL FL
33122-1087
US

IV. Provider business mailing address

2500 NW 79TH AVE STE 252
DORAL FL
33122-1087
US

V. Phone/Fax

Practice location:
  • Phone: 305-942-8511
  • Fax:
Mailing address:
  • Phone: 305-942-8511
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: BRIAN MCLAREN
Title or Position: MGR
Credential:
Phone: 305-942-8511