Individual
VITALY PILUIKO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1893 KINGSLEY AVE, STE A, ORANGE PARK, FL 32073
(904) 592-4940
(904) 400-6673
Mailing address
2137 SEDONA HILLS PKWY, LAS CRUCES, NM 88011-4135
(786) 375-0622
Taxonomy
Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
109452
FL
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
MD2019-0519
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004424700
—
FL
01
—
P01593698
MEDICARE RAILROAD
FL
Enumeration date
03/07/2006
Last updated
10/09/2024
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