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Organization
YOUR GOOD HEALTH MEDICAL GROUP PA
Active
Organization
YOUR GOOD HEALTH MEDICAL GROUP PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID VASTOLA DO (OWNER)
(561) 622-4646
Entity
Organization
Contact information
Practice address
11000 PROSPERITY FARMS RD, SUITE 206, PALM BEACH GARDENS, FL 33410-3462
(561) 622-4646
(561) 775-8625
Mailing address
11000 PROSPERITY FARMS RD, SUITE 206, PALM BEACH GARDENS, FL 33410-3462
(561) 622-4646
(561) 775-8625
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
OS0003793
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
K9758
MEDICARE PTAN
FL
Enumeration date
07/08/2006
Last updated
09/18/2009
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