| Elite Vital Care Llc | |
|
7827 N Dale Mabry Hwy Ste 108 Tampa FL 33614-3222 | |
| (813) 808-0538 | |
| Not Available |
| Full Name | Elite Vital Care Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 7827 N Dale Mabry Hwy Ste 108, Tampa, Florida |
| Authorized Official Name and Position | Yubisley Garcia (OWER) |
| Authorized Official Contact | 8138080538 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Elite Vital Care Llc 7827 N Dale Mabry Hwy Ste 108 Tampa FL 33614-3222 Ph: (813) 808-0538 | Elite Vital Care Llc 7827 N Dale Mabry Hwy Ste 108 Tampa FL 33614-3222 Ph: (813) 808-0538 |
| NPI Number | 1356047807 |
|---|---|
| Provider Enumeration Date | 02/06/2023 |
| Last Update Date | 02/06/2023 |
| Medicare PECOS PAC ID | 2264877760 |
|---|---|
| Medicare Enrollment ID | O20240223002128 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356047807 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QC1500X | Clinic/center - Community Health | (* (Not Available)) | Primary |
| Provider Name | Rolando Lazaro Leal Morell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114518958 PECOS PAC ID: 9436540747 Enrollment ID: I20211221002117 |
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