# VITA MEDICAL GROUP LLC

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

## Provider details

- **NPI number:** 1962110841
- **Authorized official:** DR. MANUEL J ORTIZ MD (PRESIDENT)
- **Authorized official phone:** (787) 618-7696

## Contact information

- **Practice address:** 1451 AVE DR. ASHFORD, SAN JUAN, PR 00907
- **Practice address phone:** (787) 893-3411
- **Mailing address:** PO BOX 1945, JUNCOS, PR 00777-1945
- **Mailing address phone:** (787) 893-3411

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207R00000X | Internal Medicine Physician | — | NULL | Yes |
| 207R00000X | Internal Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 11/09/2022
- **Last updated:** 11/09/2022