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General NPI Number Information
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NPI Number | 1821926429
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Entity Type | Organization
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Legal Business Name | VITALIFERA LLC
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Dates
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Enumeration Date | 05/12/2026
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Last Update Date | 05/12/2026
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Provider Practice Location Address
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Address Line | 2525 AVENIDA EDUARDO RUBERTE OFICINA 101
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City | PONCE
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State | PR
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Zip | 00728-1739
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Country | US
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Telephone | 787-259-5990
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 7757
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City | PONCE
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State | PR
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Zip | 00732-7757
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Country | US
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Telephone | 787-600-1138
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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 | DR. MIRIAM RIVERA MENDOZA
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Credential | MD
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Telephone | 787-600-1138
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number |
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License Number State |
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