Organization
BON VITAS MEDICAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MELISSA ORTIZ MIRANDA MD (CEO)
(407) 592-0949
Entity
Organization
Contact information
Practice address
5979 VINELAND RD STE 209, ORLANDO, FL 32819-7855
(407) 592-0949
Mailing address
15520 WATERLEIGH COVE DR, WINTER GARDEN, FL 34787-9208
(407) 592-0949
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
—
Other
Enumeration date
05/12/2022
Last updated
05/13/2022
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