Healthcare Provider Details

I. General information

NPI: 1639403066
Provider Name (Legal Business Name): VESTA SOLUTIONS GROUP, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/02/2009
Last Update Date: 11/14/2025
Certification Date: 11/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1071 S SUN DR STE 2001
LAKE MARY FL
32746-2573
US

IV. Provider business mailing address

PO BOX 952020
LAKE MARY FL
32795-2020
US

V. Phone/Fax

Practice location:
  • Phone: 407-738-4085
  • Fax: 407-469-5300
Mailing address:
  • Phone: 407-738-4085
  • Fax: 407-469-5300

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number
License Number State

VIII. Authorized Official

Name: VIJAY VONGURU
Title or Position: PRESIDENT
Credential:
Phone: 407-749-9018