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General NPI Number Information
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NPI Number | 1760017396
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Entity Type | Organization
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Legal Business Name | MY VIRTUAL DOCTOR
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Dates
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Enumeration Date | 03/04/2020
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Last Update Date | 03/04/2020
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Provider Practice Location Address
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Address Line | 7451 WILES RD STE 105
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City | CORAL SPRINGS
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State | FL
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Zip | 33067-2040
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Country | US
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Telephone | 855-803-6286
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Fax | 800-849-1727
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Provider Business Mailing Address
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Address Line | 7451 WILES RD STE 105
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City | CORAL SPRINGS
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State | FL
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Zip | 33067-2040
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Country | US
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Telephone | 855-803-6286
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Fax | 800-849-1727
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Authorized Official
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Title or Position | CEO/OWNER
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Name | MR. ADAM GREGG NADLER
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Credential |
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Telephone | 855-803-6286
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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