Provider Demographics
NPI:1871236273
Name:DOCSBY AND VITAMINISE, LLC
Entity Type:Organization
Organization Name:DOCSBY AND VITAMINISE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AO, APRN,CEO
Authorized Official - Prefix:
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:
Authorized Official - Last Name:HENSON
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:786-362-2695
Mailing Address - Street 1:437 PANDA PL
Mailing Address - Street 2:
Mailing Address - City:DAVENPORT
Mailing Address - State:FL
Mailing Address - Zip Code:33837-2688
Mailing Address - Country:US
Mailing Address - Phone:786-362-2695
Mailing Address - Fax:941-776-7787
Practice Address - Street 1:9753 S ORANGE BLOSSOM TRL
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32837-7841
Practice Address - Country:US
Practice Address - Phone:178-636-2269
Practice Address - Fax:941-776-7877
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-14
Last Update Date:2022-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty