Healthcare Provider Details

I. General information

NPI: 1861957193
Provider Name (Legal Business Name): VIGI LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/31/2019
Last Update Date: 10/04/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9149 ESTATE THOMAS PARAGON BLDG SUITE 208
ST THOMAS VI
00802
US

IV. Provider business mailing address

PO BOX 11567
ST THOMAS VI
00801-4567
US

V. Phone/Fax

Practice location:
  • Phone: 340-714-1122
  • Fax: 340-779-2443
Mailing address:
  • Phone: 340-714-1122
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number
License Number State

VIII. Authorized Official

Name: ELBA GUERRA
Title or Position: OFFICE MANAGER
Credential:
Phone: 340-714-1122