Healthcare Provider Details

I. General information

NPI: 1366357964
Provider Name (Legal Business Name): VIVO CHIROPRACTIC LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/18/2026
Last Update Date: 08/18/2026
Certification Date: 08/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2146 58TH AVE
VERO BEACH FL
32966-4647
US

IV. Provider business mailing address

2146 58TH AVE
VERO BEACH FL
32966-4647
US

V. Phone/Fax

Practice location:
  • Phone: 772-539-5151
  • Fax:
Mailing address:
  • Phone: 772-539-5151
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State

VIII. Authorized Official

Name: EDGARDO HERNANDEZ
Title or Position: MGR
Credential: DC
Phone: 561-566-9400