# VITALMD GROUP HOLDING LLC

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

## Provider details

- **NPI number:** 1871572032
- **Authorized official:** JAVIER VIZOSO (PRESIDENT)
- **Authorized official phone:** (305) 273-4641

## Contact information

- **Practice address:** 3225 AVIATION AVE, SUITE \#700, MIAMI, FL 33133-4741
- **Practice address phone:** (305) 273-4641
- **Practice address fax:** (305) 273-1497
- **Mailing address:** PO BOX 850001, DEPT 8542, ORLANDO, FL 32885-8576
- **Mailing address phone:** (305) 273-4641
- **Mailing address fax:** (305) 273-1497

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207N00000X | Dermatology Physician | — | NULL | — |
| 207N00000X | Dermatology Physician | — | — | — |
| 207Q00000X | Family Medicine Physician | — | NULL | — |
| 207Q00000X | Family Medicine Physician | — | — | — |
| 207R00000X | Internal Medicine Physician | — | NULL | — |
| 207R00000X | Internal Medicine Physician | — | — | — |
| 207RI0200X | Infectious Disease Physician | — | NULL | — |
| 207RI0200X | Infectious Disease Physician | — | — | — |
| 207V00000X | Obstetrics & Gynecology Physician | — | NULL | Yes |
| 207V00000X | Obstetrics & Gynecology Physician | — | — | Yes |
| 207VE0102X | Reproductive Endocrinology Physician | — | NULL | — |
| 207VE0102X | Reproductive Endocrinology Physician | — | — | — |
| 207VM0101X | Maternal & Fetal Medicine Physician | — | NULL | — |
| 207VM0101X | Maternal & Fetal Medicine Physician | — | — | — |
| 207VX0201X | Gynecologic Oncology Physician | — | NULL | — |
| 207VX0201X | Gynecologic Oncology Physician | — | — | — |
| 207ZP0102X | Anatomic Pathology & Clinical Pathology Physician | — | NULL | — |
| 207ZP0102X | Anatomic Pathology & Clinical Pathology Physician | — | — | — |
| 207ZP0105X | Clinical Pathology/Laboratory Medicine Physician | — | NULL | — |
| 207ZP0105X | Clinical Pathology/Laboratory Medicine Physician | — | — | — |
| 208000000X | Pediatrics Physician | — | FL | — |
| 2085R0202X | Diagnostic Radiology Physician | — | NULL | — |
| 2085R0202X | Diagnostic Radiology Physician | — | — | — |
| 208600000X | Surgery Physician | — | NULL | — |
| 208600000X | Surgery Physician | — | — | — |
| 208800000X | Urology Physician | — | NULL | — |
| 208800000X | Urology Physician | — | — | — |
| 208C00000X | Colon & Rectal Surgery Physician | — | NULL | — |
| 208C00000X | Colon & Rectal Surgery Physician | — | — | — |

## Other

- **Enumeration date:** 01/16/2006
- **Last updated:** 06/12/2026

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 269024100 | — | FL |
| 01 | — | 33217 | BCBS | FL |