Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Vita Family Medicine and Medspa LLC

Organization Family Medicine Physician · NPI 1730532359

Vita Family Medicine and Medspa LLC is a Family Medicine Physician in Leesburg, Virginia. Licensed in Virginia. Registered with an NPI since 2016.

Licensed in
VA
In the registry since
2016
Specialties on file
2
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

540 Fort Evans Rd Ste 204
Leesburg, VA 20176-3379
Phone: (703) 737-3500
Fax: (703) 737-3550
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X (VA)
Primary Care Clinic/Center Taxonomy 261QP2300X · Licence 0101258315 (VA)

Record details

NPI number1730532359
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Jennifer Boudreau — Owner/Doctor · (717) 805-8264
NPI enumeratedJuly 19, 2016
Last updated in NPPESOctober 13, 2016
Mailing address540 Fort Evans Rd, Suite 204, Leesburg, VA 20176-3379

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