Provider Demographics
NPI:1497510788
Name:AVIVIR LLC
Entity Type:Organization
Organization Name:AVIVIR LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NUTRITIONIST-DIETITIANS
Authorized Official - Prefix:MISS
Authorized Official - First Name:DEBORA
Authorized Official - Middle Name:E
Authorized Official - Last Name:SOSA CARABALLO
Authorized Official - Suffix:
Authorized Official - Credentials:LND
Authorized Official - Phone:787-605-1102
Mailing Address - Street 1:HC4BOX19756
Mailing Address - Street 2:
Mailing Address - City:GURABO
Mailing Address - State:PR
Mailing Address - Zip Code:00778
Mailing Address - Country:US
Mailing Address - Phone:787-937-4605
Mailing Address - Fax:
Practice Address - Street 1:CARR189 KM7.8
Practice Address - Street 2:
Practice Address - City:GURABO
Practice Address - State:PR
Practice Address - Zip Code:00778
Practice Address - Country:US
Practice Address - Phone:787-937-4605
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-16
Last Update Date:2024-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty