Vital Physicians PLLC

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

Legal business name

VITAL PHYSICIANS PLLC

Practice address

623 Maitland Ave Ste 1101
Altamonte Springs, FL 32701-6823

Phone

(407) 647-2009

Fax

(407) 660-2009

NPI assigned

Mar 3, 2023

Organization subpart

No

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

Authorized official

Name

Mrs. Lissette Roach

Title

Ceo

Phone

(407) 647-2009

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1677801600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1680652800000",
    "number": "1942900527",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 941912",
            "city": "MAITLAND",
            "state": "FL",
            "postal_code": "327941912",
            "telephone_number": "407-647-2009",
            "fax_number": "407-660-2009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "623 MAITLAND AVE STE 1101",
            "city": "ALTAMONTE SPRINGS",
            "state": "FL",
            "postal_code": "327016823",
            "telephone_number": "407-647-2009",
            "fax_number": "407-660-2009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VITAL PHYSICIANS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-03-03",
        "last_updated": "2023-04-05",
        "certification_date": "2023-04-05",
        "status": "A",
        "authorized_official_last_name": "ROACH",
        "authorized_official_first_name": "LISSETTE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "407-647-2009",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• All providers in Altamonte Springs, FL
• General Practice Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 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.