| Vitality Regenerative Medicine | |
|
13740 Beach Blvd Ste 105, Jacksonville, FL 32224-6034 | |
| (727) 262-4476 | |
| Not Available |
| Full Name | Vitality Regenerative Medicine |
|---|---|
| Type | Facility |
| Speciality | Chiropractor |
| Location | 13740 Beach Blvd Ste 105, Jacksonville, Florida |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1801473699 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 111N00000X | Chiropractor | (* (Not Available)) | Primary |
| Provider Name | Teresa Gail Triantafilu |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558834226 PECOS PAC ID: 1850624750 Enrollment ID: I20190607001974 |
| Provider Name | Gary K Adams |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1487772802 PECOS PAC ID: 9638270390 Enrollment ID: I20190827000287 |
| Mailing Address | Practice Location Address |
|---|---|
| Vitality Regenerative Medicine 13740 Beach Blvd Ste 105, Jacksonville, FL 32224-6034 Ph: (727) 262-4476 | Vitality Regenerative Medicine 13740 Beach Blvd Ste 105, Jacksonville, FL 32224-6034 Ph: (727) 262-4476 |
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