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General NPI Number Information
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NPI Number | 1346839107
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Entity Type | Organization
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Legal Business Name | VITAL CARE CENTER LLC
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Dates
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Enumeration Date | 01/15/2021
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Last Update Date | 10/13/2022
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Provider Practice Location Address
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Address Line | 1380 NE MIAMI GARDENS DR STE 273
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City | NORTH MIAMI BEACH
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State | FL
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Zip | 33179-4758
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Country | US
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Telephone | 305-627-3972
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Fax | 305-517-6231
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Provider Business Mailing Address
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Address Line | 1380 NE MIAMI GARDENS DR STE 273
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City | NORTH MIAMI BEACH
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State | FL
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Zip | 33179-4758
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Country | US
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Telephone | 305-627-3972
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Fax | 305-517-6231
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Authorized Official
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Title or Position | NURSE PRACTITIONER
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Name | LOUISE MARJORI PAUL
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Credential | AAPRN
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Telephone | 305-479-6649
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State |
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