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Organization
VIETRULIFE MEDICAL SPA CORP
Active
Organization
VIETRULIFE MEDICAL SPA CORP
Active
Other names
VIETRULIFE MEDICAL SPA
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ANGEL RIVERA (CFO)
(321) 333-2573
Entity
Organization
Contact information
Practice address
216 BROADWAY, KISSIMMEE, FL 34741-5768
(407) 910-4040
Mailing address
3772 EAGLE ISLE CIR, KISSIMMEE, FL 34746-1907
(321) 333-2573
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
—
Other
Enumeration date
01/24/2023
Last updated
08/24/2023
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