Vitality Ageless Center LLC
NPI 1730657271 · Multi-Specialty Clinic/Center · Suwanee, GA
Enrolled with Medicare as Part B Supplier - Clinic/Group Practice · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Provider details
- NPI number
- 1730657271
- Entity type
- Organization
- Primary specialty
- Multi-Specialty Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Julie Yu, Owner(770) 614-6266
Specialties & taxonomies
Ambulatory Health Care Facilities
- Family Medicine Physician207Q00000X
Allopathic & Osteopathic Physicians
Suppliers
- Home Health Agency251E00000X
Agencies
- Clinic/Center261Q00000X
Ambulatory Health Care Facilities
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
7 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
2 documented practice locations
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Other names (DBA / former)
- Doing business as
- Vitality Ageless Center LLC
- Doing business as
- Vitality Ageless Center LLC
Additional practice locations (1)
- 555 W Granada Blvd Ste E2Ormond Beach, FL 32174-9401Phone: (386) 260-0265
Registry dates
- Enumerated
- 2018-11-02
- Last updated
- 2024-05-09
- Certified
- 2024-05-09
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.