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General NPI Number Information
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NPI Number | 1417719428
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Entity Type | Organization
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Legal Business Name | VARGAS VITALITY CENTER, LLC
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Dates
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Enumeration Date | 01/25/2024
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Last Update Date | 01/25/2024
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Provider Practice Location Address
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Address Line | 931 N STATE ROAD 434 STE 1195
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City | ALTAMONTE SPRINGS
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State | FL
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Zip | 32714-7065
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Country | US
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Telephone | 321-279-0295
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Fax | 321-326-1819
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Provider Business Mailing Address
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Address Line | 931 N STATE ROAD 434 STE 1195
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City | ALTAMONTE SPRINGS
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State | FL
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Zip | 32714-7065
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Country | US
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Telephone | 321-279-0295
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Fax | 321-326-1819
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Authorized Official
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Title or Position | CLINICAL DIRECTOR
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Name | DR. GONZALO VARGAS
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Credential | DC
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Telephone | 321-279-0295
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number |
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License Number State |
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