Healthcare Provider Details

I. General information

NPI: 1700705977
Provider Name (Legal Business Name): VIVANOVAMED LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/13/2026
Last Update Date: 07/14/2026
Certification Date: 07/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1801 AVE PONCE DE LEON STE 308
SAN JUAN PR
00909-1917
US

IV. Provider business mailing address

1775 CALLE SANTA BRIGIDA
SAN JUAN PR
00926-4240
US

V. Phone/Fax

Practice location:
  • Phone: 305-450-4989
  • Fax:
Mailing address:
  • Phone: 305-450-4989
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: MRS. SARAHI RODRIGUEZ PEREZ
Title or Position: PRESIDENTE
Credential: MD
Phone: 305-450-4989