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General NPI Number Information
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NPI Number | 1104512979
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Entity Type | Organization
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Legal Business Name | VIRTU30 TELEHEALTH SERVICES CORP
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Dates
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Enumeration Date | 04/14/2023
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Last Update Date | 09/28/2023
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Provider Practice Location Address
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Address Line | 1540 16TH ST NE
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City | NAPLES
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State | FL
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Zip | 34120-3447
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Country | US
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Telephone | 877-298-2076
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Fax |
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Provider Business Mailing Address
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Address Line | 1540 16TH ST NE
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City | NAPLES
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State | FL
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Zip | 34120-3447
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Country | US
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Telephone | 239-877-2982
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ERIN CHRISTINE CARR
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Credential | APRN
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Telephone | 317-697-9296
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number |
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License Number State |
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