Active NPI
Victorious Health LLC
- Psychiatric/Mental Health Nurse Practitioner
- Davie, FL
National Provider Identifier
1154002855
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner
- Legal business name
- VICTORIOUS HEALTH LLC
- Doing business as
- Victorious Health LLC
- Practice address
- 10400 Griffin Rd Ste 107
Davie, FL 33328-3320 - Phone
- (786) 697-0703
- NPI assigned
- Jul 26, 2023
- Last updated
- Jan 22, 2026
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Isabelo Ian Domingo Victorio, NP
- Title
- Owner/Ceo
- Phone
- (786) 697-0703
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinic/Center | 261Q00000X | NU | ||
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | NU | Primary |
Addresses
Primary practice location
10400 Griffin Rd Ste 107
Davie, FL 33328-3320
Mailing address
5965 Stirling Rd
PMB 391
Davie, FL 33314-7225
Phone (786) 697-0703
Other names 1
- Victorious Health LLC
National Provider Directory
National Provider DirectoryLocations
5965 Stirling Rd
#391
Davie, FL 33314
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- Psychiatric/Mental Health Nurse Practitioner
- Davie, FL
- NPI 1841797842
Single Specialty
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1690329600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1769040000000",
"number": "1154002855",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5965 STIRLING RD",
"address_2": "PMB 391",
"city": "DAVIE",
"state": "FL",
"postal_code": "333147225",
"telephone_number": "786-697-0703"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10400 GRIFFIN RD STE 107",
"city": "DAVIE",
"state": "FL",
"postal_code": "333283320",
"telephone_number": "786-697-0703"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "VICTORIOUS HEALTH LLC",
"organizational_subpart": "NO",
"enumeration_date": "2023-07-26",
"last_updated": "2026-01-22",
"certification_date": "2026-01-22",
"status": "A",
"authorized_official_last_name": "VICTORIO",
"authorized_official_first_name": "ISABELO IAN",
"authorized_official_middle_name": "DOMINGO",
"authorized_official_title_or_position": "OWNER/CEO",
"authorized_official_telephone_number": "786-697-0703",
"authorized_official_credential": "NP"
},
"taxonomies": [
{
"code": "261Q00000X",
"taxonomy_group": "",
"desc": "Clinic/Center",
"state": "NU",
"license": null,
"primary": false
},
{
"code": "363LP0808X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Psychiatric/Mental Health",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Victorious Health LLC",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "Victorious Health LLC",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Davie, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.