VITALGENIX HEALTH & WELLNESS LLC NPI 1427428887

NPI Details

VITALGENIX HEALTH & WELLNESS, LLC is an internal medicine in Lake Mary, FL. The provider is a physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. VITALGENIX HEALTH & WELLNESS, LLC NPI is 1427428887. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1325 S INTERNATIONAL PKWY
SUITE 2241
LAKE MARY, FL
ZIP 32746-695
Phone: (407) 636-9663
Fax: (407) 636-9664

The provider's authorized official is Raul Enrique Tamayo .
The authorized official title is Owner and has the following contact phone number (407) 636-9663.

The CLIA number assigned to this NPI record is 10D2099192 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 9/29/2015 and was last updated on 9/29/2015.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.