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Organization
VITALMD GROUP HOLDING LLC
Active
Organization
VITALMD GROUP HOLDING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. JESSICA CAPOTE (MANAGED CARE DIRECTOR)
(305) 273-4641
Entity
Organization
Contact information
Practice address
3225 AVIATION AVE FL 4, MIAMI, FL 33133-4741
(305) 273-4641
(305) 631-7680
Mailing address
3225 AVIATION AVE FL 4, MIAMI, FL 33133-4741
(305) 273-4641
(305) 631-7680
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
NULL
101Y00000X
Counselor
—
—
103TF0000X
Family Psychologist
—
NULL
103TF0000X
Family Psychologist
—
—
104100000X
Social Worker
—
NULL
104100000X
Social Worker
—
—
106H00000X
Marriage & Family Therapist
Primary
—
NULL
106H00000X
Marriage & Family Therapist
Primary
—
—
Other
Enumeration date
08/04/2021
Last updated
08/04/2021
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