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General NPI Number Information
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NPI Number | 1063547784
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Entity Type | Organization
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Legal Business Name | VS PRIMO HEALTH CARE P A
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Dates
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Enumeration Date | 02/22/2007
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Last Update Date | 09/14/2021
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Provider Practice Location Address
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Address Line | 840 EXECUTIVE LN STE 110
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City | ROCKLEDGE
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State | FL
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Zip | 32955-3519
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Country | US
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Telephone | 321-751-7113
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Fax | 321-751-7114
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Provider Business Mailing Address
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Address Line | 840 EXECUTIVE LN STE 110
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City | ROCKLEDGE
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State | FL
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Zip | 32955-3519
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Country | US
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Telephone | 321-751-7113
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Fax | 321-751-7114
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Authorized Official
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Title or Position | MEDICAL DOCTOR
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Name | VINCENT SCIORTINO
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Credential | MD
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Telephone | 321-751-7113
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State | FL
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