Organization
VITAL PHYSICIANS PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LISSETTE ROACH (CEO)
(407) 647-2009
Entity
Organization
Contact information
Practice address
623 MAITLAND AVE STE 1101, ALTAMONTE SPRINGS, FL 32701-6823
(407) 647-2009
(407) 660-2009
Mailing address
PO BOX 941912, MAITLAND, FL 32794-1912
(407) 647-2009
(407) 660-2009
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
—
Other
Enumeration date
03/03/2023
Last updated
04/05/2023
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