Provider Demographics
NPI:1073081188
Name:VITA-HEALTH, INC.
Entity Type:Organization
Organization Name:VITA-HEALTH, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:BRIAN
Authorized Official - Last Name:PAKULA
Authorized Official - Suffix:
Authorized Official - Credentials:AP, DOM
Authorized Official - Phone:954-880-0090
Mailing Address - Street 1:12301 TAFT ST STE 200
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33026-4387
Mailing Address - Country:US
Mailing Address - Phone:954-880-0090
Mailing Address - Fax:305-421-0463
Practice Address - Street 1:12301 TAFT ST STE 200
Practice Address - Street 2:
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33026-4387
Practice Address - Country:US
Practice Address - Phone:954-880-0090
Practice Address - Fax:305-421-0463
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-11-06
Last Update Date:2018-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty