MEDICAL VITALITY CLINIC LLC (NPI# 1043858012) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1043858012 |
| Entity Type | Organization |
| Organization Name | MEDICAL VITALITY CLINIC LLC |
| Practice Address |
1845 Cordova Rd Ste 204 Fort Lauderdale FL 33316-6100 |
| Practice Telephone | 9543613343 |
| Mailing Telephone | 9543613343 |
| Enumeration Date | 2019-12-20 |
| Last Update Date | 2019-12-20 |
| Authorized Official Name | PATRICIA ANSON (DELEGATED OFFICAL) |
| Authorized Official Telephone | 3052792276 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207V00000X | Obstetrics & Gynecology | Allopathic & Osteopathic Physicians |
| Street Address |
1845 CORDOVA RD STE 204 |
| City | FORT LAUDERDALE |
| State | FL |
| Zip Code | 33316-6100 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366064040 | Jonathan David Ortiz | Behavior Technician | 1717 Se 4 Ave, Fort Lauderdale, FL 33316 | 2020-05-15 |
| 1306311626 | Gateway Recovery Center, LLC | Counselor | 1421 Sw 4th Avenue, Suite B, Fort Lauderdale, FL 33316 | 2018-10-13 |
| 1588141626 | Natan Bastoky | Family Medicine | 1600 S Andrews Ave # Gme, Fort Lauderdale, FL 33316 | 2018-07-22 |
| 1104320126 | Kathleen Kanani Graham | Pharmacist | 1401 S. Federal Highway, Ft. Lauderdale, FL 33316 | 2018-03-23 |
| 1093224271 | Lacosta Therapy, LLC | Behavioral Analyst | 412 Se 15 St., #4, Ft. Lauderdale, FL 33316 | 2017-09-20 |
| 1124560370 | Yulia Rybalka | Pharmacist | 217 Se 10th Street, Ft Lauderdale, FL 33316 | 2016-11-04 |
| 1730635376 | Brian Alexander Reyes | Specialist/Technologist | 303 Se 3rd Ave, Ft Lauderdale, FL 33316 | 2016-09-01 |
| 1649726282 | Jennifer Tabares | Specialist/Technologist | 303 Southeast 3rd Av, Fort Lauderdale, FL 33316 | 2016-09-01 |
| 1609236850 | Diane Nicole Shilling | Nurse Practitioner | 1001 South Andrews Avenue, Suite 100, Ft. Lauderdale, FL 33316 | 2016-03-01 |
| 1396113239 | Victoria Rosado | Adult Companion | 150 Se 12th Street, 401(b), Fort Lauderdale, FL 33316 | 2015-09-09 |
| Find all providers in zip 33316 | ||||
| Taxonomy Code | 207V00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Obstetrics & Gynecology |
| An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Obstetrics and Gynecology, 2007. http://www.abog.org/. American Osteopathic Board of Obstetrics and Gynecology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Obstetrics and Gynecology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Obstetrics and Gynecology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134641988 | Healthy You LLC. | Obstetrics & Gynecology | 3418 N Ocean Blvd, Fort Lauderdale, FL 33308-6902 | 2017-07-13 |
| 1609223999 | Chatoor Bisal Singh M.d., P.a | Obstetrics & Gynecology | 2620 N. Andrews Avenue, Fort Lauderdale, FL 33311 | 2016-05-17 |
| 1396108635 | Laura Baldaji Garcia | Obstetrics & Gynecology | 1600 S Andrews Ave Rm 342, Fort Lauderdale, FL 33316-2510 | 2016-04-04 |
| 1932502879 | Martha Bouza | Obstetrics & Gynecology | 609 Isle of Palms Drive, Fort Lauderdale, FL 33301 | 2014-10-07 |
| 1477811883 | Tiffannie Walker | Obstetrics & Gynecology | 4701 N. Federal Highway, Building B, Fort Lauderdale, FL 33308 | 2012-04-24 |
| 1013234590 | Angelle Brebnor | Obstetrics & Gynecology | 4701 N Federal Hwy Ste B, Fort Lauderdale, FL 33308 | 2010-04-23 |
| 1124358056 | Leonardo Nicholas Catalano Vazquez | Obstetrics & Gynecology | 1010 Seminole Dr, Apt 1106, Fort Lauderdale, FL 33304-3201 | 2009-12-26 |
| 1750509808 | Ivan Paul Chudnow | Obstetrics & Gynecology | 505 Sw 7th Ave, Fort Lauderdale, FL 33315-1041 | 2007-04-23 |
| 1073640199 | Abiola Aina Shitta-bey | Obstetrics & Gynecology | Po Box 22428, Fort Lauderdale, FL 33335-2428 | 2007-02-27 |
| 1407992167 | Sasha M Davidson | Obstetrics & Gynecology | 2151 E Commercial Blvd Ste 202, Fort Lauderdale, FL 33308-3807 | 2007-01-29 |
| Find all providers in FORT LAUDERDALE | ||||
| City | FORT LAUDERDALE |
| Zip Code | 33316 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.