OrganizationActive
Adult Vitality Healthcare LLC
NPI 1407626989 · Primary Care Nurse Practitioner · Lakeland, FL
Provider details
- NPI number
- 1407626989
- Entity type
- Organization
- Primary specialty
- Primary Care Nurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
- Organization subpart
- No
- Authorized official
- Ruth Gobourne, Mgr(863) 608-0559
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Practice location
7969 Oak Run Cir
Lakeland, FL 33809-7253
Phone: (863) 608-0559
Approximate (ZIP-level) locationGet directions
Mailing address
2946 Creeks Crossing Blvd
Lakeland, FL 33810-0216
Other names (DBA / former)
- Other name
- Adult Vitality Healthcarellc
Registry dates
- Enumerated
- 2024-01-04
- Last updated
- 2024-01-04
- Certified
- 2024-01-04
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.