Healthcare Provider Details

I. General information

NPI: 1780551275
Provider Name (Legal Business Name): MEDICA VITAE HEALTH GROUP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/20/2025
Last Update Date: 03/16/2026
Certification Date: 03/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5996 AZALEA CIR
WEST PALM BEACH FL
33415-4462
US

IV. Provider business mailing address

5996 AZALEA CIR
WEST PALM BEACH FL
33415-4462
US

V. Phone/Fax

Practice location:
  • Phone: 561-293-1494
  • Fax:
Mailing address:
  • Phone: 561-293-1494
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: NEQOUN MARQUIS JEFFRIES
Title or Position: OWNER
Credential:
Phone: 561-293-1494