Organization
VITAL IMPACT HEALTHCARE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROGER BROWN (MANAGER)
(561) 302-6086
Entity
Organization
Contact information
Practice address
1108 BELL SHOALS RD, BRANDON, FL 33511-8813
(813) 359-8787
(813) 359-8788
Mailing address
1108 BELL SHOALS RD, BRANDON, FL 33511-8813
Taxonomy
Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
—
—
305R00000X
Preferred Provider Organization
—
—
Other
Enumeration date
02/07/2024
Last updated
02/07/2024
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