Healthcare Provider Details

I. General information

NPI: 1366064735
Provider Name (Legal Business Name): VIRTUS HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/08/2020
Last Update Date: 05/08/2020
Certification Date: 05/08/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2675 HORSESHOE DR S STE 404
NAPLES FL
34104-6155
US

IV. Provider business mailing address

2675 HORSESHOE DR S STE 404
NAPLES FL
34104-6155
US

V. Phone/Fax

Practice location:
  • Phone: 180-021-0084
  • Fax:
Mailing address:
  • Phone: 180-021-0084
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MARCUS WINTERS
Title or Position: HRMANAGER
Credential:
Phone: 180-021-0081