Healthcare Provider Details
I. General information
NPI: 1699699892
Provider Name (Legal Business Name): VIRTUS HEALTH FLORIDA
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/10/2026
Last Update Date: 08/10/2026
Certification Date: 08/09/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2550 SE STATE ROAD 21
MELROSE FL
32666-5301
US
IV. Provider business mailing address
2550 SE STATE ROAD 21
MELROSE FL
32666-5301
US
V. Phone/Fax
- Phone: 352-234-6956
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207R00000X |
| Taxonomy | Internal Medicine Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
HAILEE
BANKS
Title or Position: OWNER
Credential: MD
Phone: 786-338-8729