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General NPI Number Information
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NPI Number | 1578702411
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Entity Type | Organization
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Legal Business Name | VITAL IMAGE HEALTH, LLC
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Dates
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Enumeration Date | 02/17/2009
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Last Update Date | 02/17/2009
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Provider Practice Location Address
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Address Line | 900 GLADES RD 2ND FLOOR
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City | BOCA RATON
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State | FL
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Zip | 33431-6421
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Country | US
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Telephone | 561-392-0034
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Fax | 800-928-7109
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Provider Business Mailing Address
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Address Line | 900 GLADES RD 2ND FLOOR
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City | BOCA RATON
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State | FL
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Zip | 33431-6421
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Country | US
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Telephone | 561-392-0034
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Fax | 800-928-7109
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | DR. ANGEL M. GARCIA
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Credential | M.D.
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Telephone | 561-392-0034
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | ME42709
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | ME42709
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License Number State | FL
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