Provider Demographics
NPI:1558073593
Name:VIVA AUDIOLOGY CLINIC LLC
Entity Type:Organization
Organization Name:VIVA AUDIOLOGY CLINIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:CRISTINA
Authorized Official - Middle Name:A
Authorized Official - Last Name:RIVERA FEBRES
Authorized Official - Suffix:
Authorized Official - Credentials:AUD
Authorized Official - Phone:787-469-5483
Mailing Address - Street 1:150 CONECTOR C APT 201
Mailing Address - Street 2:
Mailing Address - City:TRUJILLO ALTO
Mailing Address - State:PR
Mailing Address - Zip Code:00976-2267
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:359 CALLE SAN CLAUDIO STE 300B
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00926-4257
Practice Address - Country:US
Practice Address - Phone:787-474-9313
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-21
Last Update Date:2023-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Single Specialty