# VTSR MEDICAL CORP

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

## Provider details

- **NPI number:** 1417725961
- **Authorized official:** UMAWATTIE SUKHRAJ (PRESIDENT)
- **Authorized official phone:** (772) 812-4475

## Contact information

- **Practice address:** 1948 SE PORT ST LUCIE BLVD, PORT ST LUCIE, FL 34952-5510
- **Practice address phone:** (772) 812-4475
- **Mailing address:** 1948 SE PORT ST LUCIE BLVD, PORT ST LUCIE, FL 34952-5510
- **Mailing address phone:** (772) 812-4475

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332B00000X | Durable Medical Equipment & Medical Supplies | — | NULL | Yes |

## Other

- **Enumeration date:** 12/14/2023
- **Last updated:** 03/01/2024