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General NPI Number Information
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NPI Number | 1588537781
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Entity Type | Organization
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Legal Business Name | VITALIS CENTER LLC
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Dates
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Enumeration Date | 09/25/2025
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Last Update Date | 09/25/2025
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Provider Practice Location Address
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Address Line | 43 MELANIE LN
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City | TROY
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State | MI
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Zip | 48098-1707
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Country | US
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Telephone | 586-764-2550
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Fax |
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Provider Business Mailing Address
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Address Line | 43 MELANIE LN
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City | TROY
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State | MI
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Zip | 48098-1707
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | GIOVANNI BARBAT
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Credential |
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Telephone | 248-755-8585
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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