Vitalvida Primary Care

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

VITALVIDA PRIMARY CARE

Practice address

2820 W Charleston Blvd # D40
Las Vegas, NV 89102-1942

Phone

(915) 292-9621

NPI assigned

Jul 15, 2024

Last updated

Jul 15, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Giovanni Valenzuela

Title

Owner

Phone

(915) 292-9621

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1721001600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1721001600000",
    "number": "1326886433",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2820 W CHARLESTON BLVD # D40",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891021942"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2820 W CHARLESTON BLVD # D40",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891021942",
            "telephone_number": "915-292-9621"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VITALVIDA PRIMARY CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-07-15",
        "last_updated": "2024-07-15",
        "certification_date": "2024-07-15",
        "status": "A",
        "authorized_official_last_name": "VALENZUELA",
        "authorized_official_first_name": "GIOVANNI",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "915-292-9621"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Vitality Medical Center
• Vitality Unlimited (Vitality Integrated Programs Las Vegas)
• Vitalmind Health Services LLC
• Vitalmind Medical Center LLC
• Vitalrise Behavioral Health, PLLC
• Dan Rey Vitan
• Vitaphone U.S.a., Corporation
• Megan Vitellaro, DNP
• Regina Viterna
• Chelsea Alexis Vito, PHARMD

• Clinic/Center in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Clinic/Center in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2024; 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.