Healthcare Provider Details
I. General information
NPI: 1013562024
Provider Name (Legal Business Name): VITAE HEALTH OF FLORIDA LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/06/2019
Last Update Date: 06/16/2025
Certification Date: 06/16/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1775 HUNTINGTON LN
ROCKLEDGE FL
32955-3136
US
IV. Provider business mailing address
3450 OAKTON ST STE 300
SKOKIE IL
60076-2951
US
V. Phone/Fax
- Phone: 321-632-7341
- Fax:
- Phone: 833-848-2347
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 1041C0700X |
| Taxonomy | Clinical Social Worker |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207R00000X |
| Taxonomy | Internal Medicine Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
YITZCHAK
FREUND
Title or Position: CHIEF OPERATING OFFICER
Credential:
Phone: 224-777-8045