MEDICARE: VITAL RX LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LW0102X	Women's Health Nurse Practitioner
2	363LF0000X	Family Nurse Practitioner

General Provider Information

NPI Number	:	1861347379
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VITAL RX LLC

Provider Business Mailing Address
First Line	:	14194 SW 155TH CT
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33196-6056
Country	:	US
Telephone Number	:	305-878-8796
Fax Number	:

Provider Business Practice Location Address
First Line	:	14194 SW 155TH CT
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33196-6056
Country	:	US
Telephone Number	:	305-878-8796
Fax Number	:

Authorized Official
Title or Position	:	OWNER/NURSE PRACTITIONER
Name	:	CHYNA MOC
Credential	:	APRN
Telephone Number	:	305-878-8796

Provider Enumeration Date	:	03/02/2026
Last Update Date	:	03/02/2026

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Directions to “VITAL RX LLC ” Practice Location

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