| Vital Eagles Healthcare | |
|
13021 W Linebaugh Ave Ste 102 Tampa FL 33626-4509 | |
| (813) 709-8567 | |
| (215) 642-8552 |
| Full Name | Vital Eagles Healthcare |
|---|---|
| Speciality | General Practice |
| Location | 13021 W Linebaugh Ave Ste 102, Tampa, Florida |
| Authorized Official Name and Position | Arlenia Paulino (OWNER/PRESIDENT) |
| Authorized Official Contact | 2152052229 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Vital Eagles Healthcare 13021 W Linebaugh Ave Ste 102 Tampa FL 33626-4509 Ph: (813) 709-8567 | Vital Eagles Healthcare 13021 W Linebaugh Ave Ste 102 Tampa FL 33626-4509 Ph: (813) 709-8567 |
| NPI Number | 1225610967 |
|---|---|
| Provider Enumeration Date | 04/22/2021 |
| Last Update Date | 02/16/2024 |
| Medicare PECOS PAC ID | 8325417868 |
|---|---|
| Medicare Enrollment ID | O20221206001160 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225610967 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (* (Not Available)) | Primary |
| 342000000X | Transportation Network Company | (* (Not Available)) | Secondary |
| Provider Name | Pushpal Rocky Banerjee |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1669428371 PECOS PAC ID: 4284688771 Enrollment ID: I20050308000693 |
| Provider Name | Rene Alcides Exposito |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669012431 PECOS PAC ID: 2365857851 Enrollment ID: I20210216000042 |
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