Provider Demographics
NPI:1366778524
Name:VITALMED CORP
Entity type:Organization
Organization Name:VITALMED CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:RENE
Authorized Official - Middle Name:S
Authorized Official - Last Name:RUIZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-299-7421
Mailing Address - Street 1:7603 GUNN HWY
Mailing Address - Street 2:SUITE C
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33625-3164
Mailing Address - Country:US
Mailing Address - Phone:813-926-7775
Mailing Address - Fax:
Practice Address - Street 1:7603 GUNN HWY
Practice Address - Street 2:SUITE C
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33625-3164
Practice Address - Country:US
Practice Address - Phone:813-926-7775
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-23
Last Update Date:2009-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment