Individual
MR. GERALD VITAL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
BA, CBHCM
Contact information
Practice address
1400 NE 125TH ST, NORTH MIAMI, FL 33161-6034
(305) 915-8900
Mailing address
1400 NE 125TH ST, NORTH MIAMI, FL 33161-6034
(305) 915-8900
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
11/30/2021
Last updated
11/30/2021
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