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General NPI Number Information
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NPI Number | 1255250205
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Entity Type | Organization
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Legal Business Name | VIVABLUE MEDICAL & WELLNESS LLC
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Dates
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Enumeration Date | 07/14/2026
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Last Update Date | 07/14/2026
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Provider Practice Location Address
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Address Line | 3000 N UNIVERSITY DR STE 2E
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City | CORAL SPRINGS
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State | FL
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Zip | 33065-5055
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Country | US
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Telephone | 754-264-3872
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Fax |
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Provider Business Mailing Address
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Address Line | 6289 NW 62ND TER
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City | PARKLAND
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State | FL
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Zip | 33067-1535
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Country | US
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Telephone | 754-264-3872
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Fax |
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Authorized Official
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Title or Position | OWNER/MGR
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Name | LAURA MCMILLAN-ZITON
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Credential | DO
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Telephone | 754-264-3872
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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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