Provider Demographics
NPI:1437900784
Name:DRIP VITALS LLC
Entity Type:Organization
Organization Name:DRIP VITALS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:EMMANUE NOEL
Authorized Official - Middle Name:CRUZ
Authorized Official - Last Name:TANCINCO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:888-868-9906
Mailing Address - Street 1:33 SW 2ND AVE
Mailing Address - Street 2:STE 401
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33130
Mailing Address - Country:US
Mailing Address - Phone:888-868-9906
Mailing Address - Fax:
Practice Address - Street 1:33 SW 2ND AVE
Practice Address - Street 2:STE 401
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33130
Practice Address - Country:US
Practice Address - Phone:888-868-9906
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-27
Last Update Date:2024-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No207RB0002XAllopathic & Osteopathic PhysiciansInternal MedicineObesity MedicineGroup - Multi-Specialty