Healthcare Provider Details

I. General information

NPI: 1801408489
Provider Name (Legal Business Name): VACCINES & VITAMINS WELLNESS CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/17/2020
Last Update Date: 08/20/2020
Certification Date: 08/20/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

293 AVE WINSTON CHURCHILL
SAN JUAN PR
00926-6604
US

IV. Provider business mailing address

936 DOLORES P MARCHAND URB VILLAS DE RIO CANAS
PONCE PR
00728-1928
US

V. Phone/Fax

Practice location:
  • Phone: 787-944-5632
  • Fax:
Mailing address:
  • Phone: 787-944-5632
  • 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: DANIA L COLON ALVARADO
Title or Position: ADMINISTRADORA
Credential:
Phone: 787-432-7090