Organization
ADULT VITALITY HEALTHCARE LLC
Active
Other names
ADULT VITALITY HEALTHCARELLC
Organization subpart
No
Provider details
NPI number
Authorized official
RUTH GOBOURNE (MGR)
(863) 608-0559
Entity
Organization
Contact information
Practice address
7969 OAK RUN CIR, LAKELAND, FL 33809-7253
(863) 608-0559
Mailing address
2946 CREEKS CROSSING BLVD, LAKELAND, FL 33810-0216
(863) 608-0559
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
—
—
Other
Enumeration date
01/04/2024
Last updated
01/04/2024
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