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General NPI Number Information
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NPI Number | 1134372782
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Entity Type | Organization
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Legal Business Name | VITAL FUNCTION, LLC
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Dates
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Enumeration Date | 10/28/2008
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Last Update Date | 05/24/2011
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Provider Practice Location Address
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Address Line | 2704 N UNIVERSITY DR
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City | SUNRISE
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State | FL
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Zip | 33322-2435
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Country | US
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Telephone | 954-306-6276
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Fax | 800-928-7109
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Provider Business Mailing Address
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Address Line | 7040 W PALMETTO PARK RD STE 4-254
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City | BOCA RATON
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State | FL
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Zip | 33433-3407
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Country | US
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Telephone | 954-306-6276
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Fax | 800-928-7109
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Authorized Official
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Title or Position | OPERATING MANAGER
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Name | MS. MARIA DEL CARMEN BELTRAN
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Credential |
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Telephone | 954-306-6276
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QX0100X
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Taxonomy Name | Occupational Medicine Clinic/Center
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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 | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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