# MEDICA VITA LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1205370848
- **Authorized official:** ANDRIY CHETIN AP (MANAGER)
- **Authorized official phone:** (407) 936-4238

## Contact information

- **Practice address:** 710 W PRINCETON ST, SUITE A, ORLANDO, FL 32804-5214
- **Practice address phone:** (407) 936-4238
- **Mailing address:** 5357 BAMBOO CT, ORLANDO, FL 32811-6723
- **Mailing address phone:** (407) 936-4238

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 171100000X | Acupuncturist | 3700 | FL | Yes |

## Other

- **Enumeration date:** 12/16/2016
- **Last updated:** 12/16/2016

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 171100000X | ACUPUNCTURIST | FL |