Provider Demographics
NPI:1649988221
Name:VITA HEALTH GROUP FL LLC
Entity type:Organization
Organization Name:VITA HEALTH GROUP FL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP OF OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:ERIKA
Authorized Official - Middle Name:
Authorized Official - Last Name:BOODHOO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-854-9660
Mailing Address - Street 1:333 NE 2ND ST
Mailing Address - Street 2:
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33483-4522
Mailing Address - Country:US
Mailing Address - Phone:954-854-9660
Mailing Address - Fax:
Practice Address - Street 1:3351 NW BOCA RATON BLVD
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33431-6623
Practice Address - Country:US
Practice Address - Phone:954-854-9660
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-11
Last Update Date:2025-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty