Provider Demographics
NPI:1639403066
Name:VESTA SOLUTIONS GROUP, LLC
Entity Type:Organization
Organization Name:VESTA SOLUTIONS GROUP, LLC
Other - Org Name:VESTA TELERADIOLOGY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:VIJAY
Authorized Official - Middle Name:
Authorized Official - Last Name:VONGURU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-749-9018
Mailing Address - Street 1:PO BOX 952020
Mailing Address - Street 2:
Mailing Address - City:LAKE MARY
Mailing Address - State:FL
Mailing Address - Zip Code:32795-2020
Mailing Address - Country:US
Mailing Address - Phone:407-738-4085
Mailing Address - Fax:407-469-5300
Practice Address - Street 1:1071 S SUN DR STE 2001
Practice Address - Street 2:
Practice Address - City:LAKE MARY
Practice Address - State:FL
Practice Address - Zip Code:32746-2573
Practice Address - Country:US
Practice Address - Phone:407-738-4085
Practice Address - Fax:407-469-5300
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-02
Last Update Date:2023-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty