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NPI Code Detail

MEDICARE: VITALSHAPE WELLNESS LLC

MEDICARE: VITALSHAPE WELLNESS LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1163WI0500XInfusion Therapy Registered Nurse

General Provider Information

NPI Number : 1275495954
Entity Type Code : Organization
Provider Name (Legal Business Name) : VITALSHAPE WELLNESS LLC
Provider Business Mailing Address
First Line : URB MANS DE LAS PIEDRAS 79
Second Line : PIETRANOVA F7
City : LAS PIEDRAS
State : PR
Zip : 00771-3713
Country : US
Telephone Number : 939-246-2821
Fax Number :
Provider Business Practice Location Address
First Line : URB MANS DE LAS PIEDRAS 79
Second Line : PIETRANOVA F7
City : LAS PIEDRAS
State : PR
Zip : 00771-3713
Country : US
Telephone Number : 939-246-2821
Fax Number :
Authorized Official
Title or Position : OWNER / MANAGING MEMBER
Name : XIOMARA FLECHA RODRIGUEZ
Credential : RN BSN,MSN
Telephone Number : 939-246-2821
Provider Enumeration Date : 12/01/2025
Last Update Date : 12/01/2025

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Directions to “VITALSHAPE WELLNESS LLC ” Practice Location

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