Healthcare Provider Details

I. General information

NPI: 1407889793
Provider Name (Legal Business Name): QUANTUM VITALITY CENTRES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/09/2006
Last Update Date: 02/01/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2905 TRAVERSE TRL
THE VILLAGES FL
32163-2017
US

IV. Provider business mailing address

2905 TRAVERSE TRL
THE VILLAGES FL
32163-2017
US

V. Phone/Fax

Practice location:
  • Phone: 352-430-3399
  • Fax: 888-241-0433
Mailing address:
  • Phone: 352-430-3399
  • Fax: 888-241-0433

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberCH6989
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: PETER JACOB SZAKACS
Title or Position: OWNER
Credential: DC
Phone: 813-312-3526