Healthcare Provider Details

I. General information

NPI: 1194458760
Provider Name (Legal Business Name): VITALEXAM LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/01/2022
Last Update Date: 12/22/2025
Certification Date: 12/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

945 W MICHIGAN AVE STE 10B
PENSACOLA FL
32505-2301
US

IV. Provider business mailing address

945 W MICHIGAN AVE STE 10B
PENSACOLA FL
32505-2301
US

V. Phone/Fax

Practice location:
  • Phone: 888-850-3926
  • Fax: 850-429-4313
Mailing address:
  • Phone: 888-850-3926
  • Fax: 850-985-3926

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2083X0100X
TaxonomyOccupational Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QC1800X
TaxonomyCorporate Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. MARCI J VITALE
Title or Position: CEO
Credential: DNP FNP-BC AGACNP-BC
Phone: 888-850-3926