Organization
MEDICA VITA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANDRIY CHETIN AP (MANAGER)
(407) 936-4238
Entity
Organization
Contact information
Practice address
710 W PRINCETON ST, SUITE A, ORLANDO, FL 32804-5214
(407) 936-4238
Mailing address
5357 BAMBOO CT, ORLANDO, FL 32811-6723
(407) 936-4238
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
3700
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
171100000X
ACUPUNCTURIST
FL
Enumeration date
12/16/2016
Last updated
12/16/2016
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