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Organization

VITALMD GROUP HOLDING LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. FRANCISCO J LEON (EXECUTIVE DIRECTOR)
(305) 273-4641
Entity
Organization

Contact information

Practice address
3225 AVIATION AVE, SUITE #700, MIAMI, FL 33133-4741
(305) 273-4641
(305) 273-1497
Mailing address
PO BOX 432040, MIAMI, FL 33243-2040
(305) 273-4641
(305) 273-1497

Taxonomy

Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
207Q00000X
Family Medicine Physician
207R00000X
Internal Medicine Physician
207RI0200X
Infectious Disease Physician
207V00000X
Obstetrics & Gynecology Physician
Primary
207VE0102X
Reproductive Endocrinology Physician
207VM0101X
Maternal & Fetal Medicine Physician
207VX0201X
Gynecologic Oncology Physician
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
207ZP0105X
Clinical Pathology/Laboratory Medicine Physician
208000000X
Pediatrics Physician
FL
2085R0202X
Diagnostic Radiology Physician
208600000X
Surgery Physician
208800000X
Urology Physician
208C00000X
Colon & Rectal Surgery Physician

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
269024100
FL
01
33217
BCBS
FL
Enumeration date
01/16/2006
Last updated
12/23/2013
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