VB Med LLC

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Legal business name

VB MED LLC

Practice address

12230 Legacy Bright St
Riverview, FL 33578-4069

Phone

(813) 575-0363

Fax

(813) 669-5614

NPI assigned

Feb 16, 2023

Organization subpart

No

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

Authorized official

Name

Victoria Alice Boisselle, PA

Title

President

Phone

(813) 575-0363

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1676505600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1676505600000",
    "number": "1639877053",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12230 LEGACY BRIGHT ST",
            "city": "RIVERVIEW",
            "state": "FL",
            "postal_code": "335784069",
            "telephone_number": "813-575-0363",
            "fax_number": "813-669-5614"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12230 LEGACY BRIGHT ST",
            "city": "RIVERVIEW",
            "state": "FL",
            "postal_code": "335784069",
            "telephone_number": "813-575-0363",
            "fax_number": "813-669-5614"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VB MED LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-02-16",
        "last_updated": "2023-02-16",
        "certification_date": "2023-02-16",
        "status": "A",
        "authorized_official_last_name": "BOISSELLE",
        "authorized_official_first_name": "VICTORIA",
        "authorized_official_middle_name": "ALICE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "813-575-0363",
        "authorized_official_credential": "PA"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Vallo Riverview, PLLC (The Dental Boutique Riverview)
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• Lisa Vargas
• Cassandra Maria Vazquez, APRN
• Cristina Vazquez
• Amy Vega
• Luisa Vega
• Sophia B Vega
• Stephanie Vega
• Maria Elena Velasco Fontaine, MS

• Physician Assistant in Riverview, FL
• Providers in Riverview, FL by specialty
• Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2023; 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.