NPIMap

Organization Active NPI

Vitalmd Group Holding LLC

  • Marriage & Family Therapist
  • Miami, FL
National Provider Identifier
1043984941
Registry record updated Aug 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
Legal business name
VITALMD GROUP HOLDING LLC
Practice address
3225 Aviation Ave FL 4
Miami, FL 33133-4741
Phone
(305) 273-4641
Fax
(305) 631-7680
NPI assigned
Aug 4, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Ms. Jessica Capote
Title
Managed Care Director
Phone
(305) 273-4641

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101Y00000X
Family PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TF0000X
Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 104100000X
Marriage & Family TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 106H00000X Primary

Addresses

Primary practice location

3225 Aviation Ave FL 4
Miami, FL 33133-4741

Mailing address

3225 Aviation Ave FL 4
Miami, FL 33133-4741
Phone (305) 273-4641

Other identifiers 1

IdentifierTypeStateIssuer
269024100MedicaidFL

National Provider Directory

National Provider Directory
Tax ID family
Medipath LLC11 organizations share this tax ID, including this one

Other organizations with this tax ID 10

Organizations that report the same tax identification number in the National Provider Directory.

Locations

3225 Aviation Ave
Fl 4
Miami, FL 33133
Phone (305) 273-4641

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1628035200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1628035200000",
    "number": "1043984941",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3225 AVIATION AVE FL 4",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331334741",
            "telephone_number": "305-273-4641",
            "fax_number": "305-631-7680"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3225 AVIATION AVE FL 4",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331334741",
            "telephone_number": "305-273-4641",
            "fax_number": "305-631-7680"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VITALMD GROUP HOLDING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-08-04",
        "last_updated": "2021-08-04",
        "certification_date": "2021-08-04",
        "status": "A",
        "authorized_official_last_name": "CAPOTE",
        "authorized_official_first_name": "JESSICA",
        "authorized_official_title_or_position": "MANAGED CARE DIRECTOR",
        "authorized_official_telephone_number": "305-273-4641",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Family",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "269024100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.