Healthcare Provider Details

I. General information

NPI: 1437027919
Provider Name (Legal Business Name): VITALPATH WELLNESS SOLUTIONS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/27/2025
Last Update Date: 09/04/2026
Certification Date: 09/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17608 SW 144TH AVE
MIAMI FL
33177-2669
US

IV. Provider business mailing address

17608 SW 144TH AVE
MIAMI FL
33177-2669
US

V. Phone/Fax

Practice location:
  • Phone: 786-617-9704
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number StateNULL

VIII. Authorized Official

Name: MS. NATACHA BERMUDEZ FERNANDEZ
Title or Position: ARNP
Credential:
Phone: 786-617-9704