American Vitality Medical Group, LLC.
Organization Active NPI Multi-Specialty Clinic/Center · Leesburg, FL
NPI 1649026428 · NPPES record last updated Apr 24, 2024
Key facts
- NPI
- 1649026428
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Multi-Specialty Clinic/Center 261QM1300X
- Legal business name
- AMERICAN VITALITY MEDICAL GROUP, LLC.
- Practice address
- 4120 Corley Island Rd Ste 500
Leesburg, FL 34748-8297 - Phone
- (727) 415-7253
- NPI assigned
- Apr 24, 2024
- Organization subpart
- No
Authorized official
- Name
- Mr. Douglas Rodante
- Title
- President
- Phone
- (727) 415-7253
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician |
207Q00000X | |||
| Multi-Specialty Clinic/Center | 261QM1300X | Yes |
Addresses
Primary practice location
4120 Corley Island Rd Ste 500
Leesburg, FL 34748-8297
Mailing address
1100 Lake Dora Dr
Tavares, FL 32778-3529
Phone (727) 415-7253
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- Travis Ammons
- Jon E. Anderson
- Michael Angelo Anderson
- Waleska Llorens Anderson
- Andrew B Sher MD PA
All providers in Leesburg, FL · Multi-Specialty Clinic/Center in Florida
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 24, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.