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General NPI Number Information
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NPI Number | 1801473699
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Entity Type | Organization
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Legal Business Name | VITALITY REGENERATIVE MEDICINE
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Dates
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Enumeration Date | 03/26/2021
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Last Update Date | 04/07/2025
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Provider Practice Location Address
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Address Line | 19105 N US HIGHWAY 41 STE 300
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City | LUTZ
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State | FL
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Zip | 33549-4206
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Country | US
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Telephone | 727-580-7290
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Fax |
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Provider Business Mailing Address
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Address Line | 2003 CLEMENT ST
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City | NOLENSVILLE
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State | TN
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Zip | 37135-1047
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Country | US
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Telephone | 727-580-7290
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DAVID MAGNANO
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Credential | DC
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Telephone | 727-580-7290
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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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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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