# BON VITAS MEDICAL LLC

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

## Provider details

- **NPI number:** 1750027660
- **Authorized official:** MELISSA ORTIZ MIRANDA MD (CEO)
- **Authorized official phone:** (407) 592-0949

## Contact information

- **Practice address:** 5979 VINELAND RD STE 209, ORLANDO, FL 32819-7855
- **Practice address phone:** (407) 592-0949
- **Mailing address:** 15520 WATERLEIGH COVE DR, WINTER GARDEN, FL 34787-9208
- **Mailing address phone:** (407) 592-0949

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208D00000X | General Practice Physician | — | — | Yes |

## Other

- **Enumeration date:** 05/12/2022
- **Last updated:** 05/13/2022