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General NPI Number Information
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NPI Number | 1275495954
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Entity Type | Organization
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Legal Business Name | VITALSHAPE WELLNESS LLC
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Dates
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Enumeration Date | 12/01/2025
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Last Update Date | 12/01/2025
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Provider Practice Location Address
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Address Line | URB MANS DE LAS PIEDRAS 79 PIETRANOVA F7
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City | LAS PIEDRAS
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State | PR
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Zip | 00771-3713
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Country | US
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Telephone | 939-246-2821
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Fax |
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Provider Business Mailing Address
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Address Line | URB MANS DE LAS PIEDRAS 79 PIETRANOVA F7
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City | LAS PIEDRAS
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State | PR
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Zip | 00771-3713
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Country | US
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Telephone | 939-246-2821
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Fax |
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Authorized Official
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Title or Position | OWNER / MANAGING MEMBER
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Name | XIOMARA FLECHA RODRIGUEZ
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Credential | RN BSN,MSN
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Telephone | 939-246-2821
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WI0500X
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Taxonomy Name | Infusion Therapy Registered Nurse
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License Number |
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License Number State |
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