Healthcare Provider Details

I. General information

NPI: 1316657224
Provider Name (Legal Business Name): HOLISTICA VIDA LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/01/2022
Last Update Date: 01/11/2026
Certification Date: 01/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

URB. LA RAMBLA CALLE CLARISAS 1283
PONCE PR
00730
US

IV. Provider business mailing address

URB. LA RAMBLA CALLE CLARISAS 1283
PONCE PR
00730-4044
US

V. Phone/Fax

Practice location:
  • Phone: 787-298-9252
  • Fax:
Mailing address:
  • Phone: 787-298-9252
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. MANUEL A CONESA FIGUEROA
Title or Position: OWNER
Credential: ND
Phone: 787-400-9704