Provider Demographics
NPI:1134955818
Name:VIBRAS NUTRITIVAS
Entity type:Organization
Organization Name:VIBRAS NUTRITIVAS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DESIREE
Authorized Official - Middle Name:
Authorized Official - Last Name:APONTE CASABLANCA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-313-1883
Mailing Address - Street 1:J3 CALLE PASEO DE LA REINA
Mailing Address - Street 2:
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00969-5253
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:SUITE 201 PLAZA GUAYNABO
Practice Address - Street 2:EDF. CARIBBEAN CINEMAS
Practice Address - City:GUAYNABO
Practice Address - State:PR
Practice Address - Zip Code:00969-3323
Practice Address - Country:US
Practice Address - Phone:787-731-4949
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-10
Last Update Date:2024-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty