Healthcare Provider Details

I. General information

NPI: 1184541351
Provider Name (Legal Business Name): VITA AUREA MD, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/30/2026
Last Update Date: 06/30/2026
Certification Date: 06/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

27 CHALETS DE SANTA MARIA
SAN JUAN PR
00927-6636
US

IV. Provider business mailing address

27 CHALETS DE SANTA MARIA
SAN JUAN PR
00927-6636
US

V. Phone/Fax

Practice location:
  • Phone: 787-632-4306
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State

VIII. Authorized Official

Name: NATALIA CARDENAS SUAREZ
Title or Position: MEMBER
Credential: MD
Phone: 787-632-4306