Provider Demographics
NPI:1508531153
Name:VITALIEF MEDICAL CENTER INC
Entity type:Organization
Organization Name:VITALIEF MEDICAL CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:RAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:CASTILLO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-234-4956
Mailing Address - Street 1:1650 SAND LAKE RD STE 114A
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32809-7712
Mailing Address - Country:US
Mailing Address - Phone:407-988-1177
Mailing Address - Fax:407-598-5583
Practice Address - Street 1:1650 SAND LAKE RD STE 114A
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32809-7712
Practice Address - Country:US
Practice Address - Phone:407-988-1177
Practice Address - Fax:407-598-5583
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-14
Last Update Date:2025-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center