=====================================================
General NPI Number Information
=====================================================
NPI Number | 1992818025
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | VIVA MAS VIVA MEJOR INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/15/2006
-----------------------------------------------------
Last Update Date | 08/26/2009
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | BALDIOROTY #26
-----------------------------------------------------
City | CAGUAS
-----------------------------------------------------
State | PR
-----------------------------------------------------
Zip | 00745
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 787-258-9693
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 1240
-----------------------------------------------------
City | CAGUAS
-----------------------------------------------------
State | PR
-----------------------------------------------------
Zip | 00726
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 787-258-9693
-----------------------------------------------------
Fax | 787-258-9694
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | MRS. MILAGROS DEL C GARCIA
-----------------------------------------------------
Credential | MS
-----------------------------------------------------
Telephone | 787-258-9693
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261Q00000X
-----------------------------------------------------
Taxonomy Name | Clinic/Center
-----------------------------------------------------
License Number | 271
-----------------------------------------------------
License Number State | PR
-----------------------------------------------------