| Vital Physicians Pllc | |
|
623 Maitland Ave Ste 1101 Altamonte Springs FL 32701-6823 | |
| (407) 647-2009 | |
| (407) 660-2009 |
| Full Name | Vital Physicians Pllc |
|---|---|
| Speciality | General Practice |
| Location | 623 Maitland Ave Ste 1101, Altamonte Springs, Florida |
| Authorized Official Name and Position | Lissette Roach (CEO) |
| Authorized Official Contact | 4076472009 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Vital Physicians Pllc Po Box 941912 Maitland FL 32794-1912 Ph: (407) 647-2009 | Vital Physicians Pllc 623 Maitland Ave Ste 1101 Altamonte Springs FL 32701-6823 Ph: (407) 647-2009 |
| NPI Number | 1942900527 |
|---|---|
| Provider Enumeration Date | 03/03/2023 |
| Last Update Date | 04/05/2023 |
| Medicare PECOS PAC ID | 6709241284 |
|---|---|
| Medicare Enrollment ID | O20230505002076 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1942900527 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (* (Not Available)) | Primary |
| Provider Name | Jason Donald Schultz |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1356366884 PECOS PAC ID: 4284637463 Enrollment ID: I20070404000158 |
| Provider Name | Erik D Roach |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1770781072 PECOS PAC ID: 4385794734 Enrollment ID: I20090605000609 |
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