# VITAL PHYSICIANS PLLC

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

## Provider details

- **NPI number:** 1942900527
- **Authorized official:** MRS. LISSETTE ROACH (CEO)
- **Authorized official phone:** (407) 647-2009

## Contact information

- **Practice address:** 623 MAITLAND AVE STE 1101, ALTAMONTE SPRINGS, FL 32701-6823
- **Practice address phone:** (407) 647-2009
- **Practice address fax:** (407) 660-2009
- **Mailing address:** PO BOX 941912, MAITLAND, FL 32794-1912
- **Mailing address phone:** (407) 647-2009
- **Mailing address fax:** (407) 660-2009

## Taxonomy

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

## Other

- **Enumeration date:** 03/03/2023
- **Last updated:** 04/05/2023