Provider Demographics
NPI:1750368007
Name:MEDICAL TECHNOLOGIES UNLIMITED INC
Entity type:Organization
Organization Name:MEDICAL TECHNOLOGIES UNLIMITED INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MARCO
Authorized Official - Middle Name:N
Authorized Official - Last Name:VITIELLO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-595-7177
Mailing Address - Street 1:P.O. BOX 56-6207
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33256
Mailing Address - Country:US
Mailing Address - Phone:305-595-7177
Mailing Address - Fax:
Practice Address - Street 1:4000 PONCE DE LEON
Practice Address - Street 2:SUITE 470
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33146
Practice Address - Country:US
Practice Address - Phone:305-595-7177
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-28
Last Update Date:2009-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0038819261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLME0038819OtherMEDICAL LICENSE
FL067554700Medicaid
FL=========OtherTAX ID
FL=========OtherTAX ID