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General NPI Number Information
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NPI Number | 1841913357
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Entity Type | Organization
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Legal Business Name | VITALBRIDGE HEALTH PLLC
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Dates
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Enumeration Date | 09/20/2022
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Last Update Date | 03/19/2024
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Provider Practice Location Address
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Address Line | 1325 S CONGRESS AVE STE 109
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City | BOYNTON BEACH
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State | FL
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Zip | 33426-5802
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Country | US
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Telephone | 561-823-1020
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Fax | 561-708-4003
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Provider Business Mailing Address
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Address Line | 1325 S CONGRESS AVE STE 109
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City | BOYNTON BEACH
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State | FL
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Zip | 33426-5802
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Country | US
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Telephone | 561-823-1020
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Fax | 561-708-4003
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Authorized Official
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Title or Position | PROVIDER / OWNER
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Name | JAY KYLE OBER
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Credential | PHD, APRN
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Telephone | 561-823-1020
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State |
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