=====================================================
General NPI Number Information
=====================================================
NPI Number | 1285269837
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | SUNVITAL HEALTHCARE CENTER CORP
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/04/2020
-----------------------------------------------------
Last Update Date | 01/26/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 7270 NW 12TH ST STE 420
-----------------------------------------------------
City | MIAMI
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33126-1941
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 305-723-9391
-----------------------------------------------------
Fax | 786-478-3427
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 7270 NW 12TH ST STE 420
-----------------------------------------------------
City | MIAMI
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33126-1941
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 305-723-9391
-----------------------------------------------------
Fax | 786-478-3427
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | YOEL SANTANA
-----------------------------------------------------
Credential | APRN
-----------------------------------------------------
Telephone | 305-267-6060
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207V00000X
-----------------------------------------------------
Taxonomy Name | Obstetrics & Gynecology Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 207QS0010X
-----------------------------------------------------
Taxonomy Name | Sports Medicine (Family Medicine) Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
Taxonomy Code | 208D00000X
-----------------------------------------------------
Taxonomy Name | General Practice Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #4
-----------------------------------------------------
Taxonomy Code | 2084P0800X
-----------------------------------------------------
Taxonomy Name | Psychiatry Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------