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)CodeLicenseStatePrimary
Family Medicine Physician
Group: 193200000X MULTI-SPECIALTY GROUP
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

Other providers in Leesburg, FL

All providers in Leesburg, FL · Multi-Specialty Clinic/Center in Florida

Sources for this page

Verify at the official NPI Registry.