MEDICARE: SAHIRA VIVONI M.D.

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
1	208D00000X	General Practice Physician	15203	PR

General Provider Information

NPI Number	:	1346250354
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SAHIRA VIVONI M.D.

Provider Business Mailing Address
First Line	:	PO BOX 6646
Second Line	:
City	:	CAGUAS
State	:	PR
Zip	:	00726-6646
Country	:	US
Telephone Number	:	787-746-2065
Fax Number	:	787-746-2085

Provider Business Practice Location Address
First Line	:	METRO PLAZA L14-D
Second Line	:	AVE. JOSE GARRIDO
City	:	CAGUAS
State	:	PR
Zip	:	00725
Country	:	US
Telephone Number	:	787-430-3025
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/09/2006
Last Update Date	:	05/27/2026

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