Active NPI
Vitality Regenerative Medicine
- Internal Medicine Physician
- Lutz, FL
National Provider Identifier
1801473699
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- Legal business name
- VITALITY REGENERATIVE MEDICINE
- Practice address
- 19105 N US Highway 41 Ste 300
Lutz, FL 33549-4206 - Phone
- (727) 580-7290
- NPI assigned
- Mar 26, 2021
- 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
- David Magnano, DC
- Title
- Owner
- Phone
- (727) 580-7290
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 |
|---|---|---|---|---|
| Chiropractor | 111N00000X | |||
| Internal Medicine Physician | 207R00000X | Primary |
Addresses
Primary practice location
19105 N US Highway 41 Ste 300
Lutz, FL 33549-4206
Mailing address
2003 Clement St
Nolensville, TN 37135-1047
Phone (727) 580-7290
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL, IL
Enrollment records 2
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20231211000778 | FL | Part B Supplier - Clinic/Group Practice | 3971903410 |
Receives reassigned benefits from 3 practitioners Practice locations: Tampa, FL |
| O20250922002177 | IL | Part B Supplier - Clinic/Group Practice | 3971903410 |
Receives reassigned benefits from 2 practitioners Practice locations: Romeoville, IL |
National Provider Directory
National Provider DirectoryLocations
7177 Nolensville Rd
Nolensville, TN 37135
Phone (615) 200-7639
Practitioners & affiliated clinicians
Practitioners 5
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Family Nurse Practitioner
- Champions Gate, FL
- NPI 1740948355
FL
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1616716800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1743984000000",
"number": "1801473699",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2003 CLEMENT ST",
"city": "NOLENSVILLE",
"state": "TN",
"postal_code": "371351047",
"telephone_number": "727-580-7290"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "19105 N US HIGHWAY 41 STE 300",
"city": "LUTZ",
"state": "FL",
"postal_code": "335494206",
"telephone_number": "727-580-7290"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "VITALITY REGENERATIVE MEDICINE",
"organizational_subpart": "NO",
"enumeration_date": "2021-03-26",
"last_updated": "2025-04-07",
"certification_date": "2025-04-07",
"status": "A",
"authorized_official_last_name": "MAGNANO",
"authorized_official_first_name": "DAVID",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "727-580-7290",
"authorized_official_credential": "DC"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Chiropractor",
"state": null,
"license": null,
"primary": false
},
{
"code": "207R00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Internal Medicine",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lutz, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.