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General NPI Number Information
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NPI Number | 1366849499
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Entity Type | Organization
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Legal Business Name | VITAL MEDICAL HEATH INC
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Dates
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Enumeration Date | 12/04/2014
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Last Update Date | 06/20/2018
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Provider Practice Location Address
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Address Line | 330 SW 27TH AVE STE 706
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City | MIAMI
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State | FL
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Zip | 33135-2968
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Country | US
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Telephone | 786-534-7950
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Fax | 786-534-7195
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Provider Business Mailing Address
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Address Line | 330 SW 27TH AVE STE 706
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City | MIAMI
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State | FL
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Zip | 33135-2968
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Country | US
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Telephone | 786-534-7950
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Fax | 786-534-7195
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Authorized Official
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Title or Position | OWNER
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Name | DUNIA FLOREZ
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Credential |
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Telephone | 786-534-7950
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | MA 45352
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License Number State | FL
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