Healthcare Provider Details

I. General information

NPI: 1871337352
Provider Name (Legal Business Name): VITAL HEALTHCARE CENTERS CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/20/2024
Last Update Date: 02/13/2025
Certification Date: 02/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1601 N PALM AVE STE 102
PEMBROKE PINES FL
33026-3240
US

IV. Provider business mailing address

1601 N PALM AVE STE 102
PEMBROKE PINES FL
33026-3240
US

V. Phone/Fax

Practice location:
  • Phone: 646-342-5508
  • Fax:
Mailing address:
  • Phone: 646-342-5508
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. PEDRO L SANCHEZ BENITES
Title or Position: OWNER/ ADMINISTRATOR
Credential:
Phone: 954-681-4317