Organization
AMERICAN VITALITY MEDICAL GROUP, LLC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DOUGLAS RODANTE (PRESIDENT)
(727) 415-7253
Entity
Organization
Contact information
Practice address
4120 CORLEY ISLAND RD STE 500, LEESBURG, FL 34748-8297
(727) 415-7253
Mailing address
1100 LAKE DORA DR, TAVARES, FL 32778-3529
(727) 415-7253
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
Other
Enumeration date
04/24/2024
Last updated
04/24/2024
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