Provider Demographics
NPI:1750185708
Name:IMPULSO VITAL LLC
Entity type:Organization
Organization Name:IMPULSO VITAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HERNAN
Authorized Official - Middle Name:N
Authorized Official - Last Name:LOPEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-671-7088
Mailing Address - Street 1:B3 CALLE MARGINAL
Mailing Address - Street 2:URB VILLA LISSETTE
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00969-3421
Mailing Address - Country:US
Mailing Address - Phone:787-999-6570
Mailing Address - Fax:
Practice Address - Street 1:B3 CALLE MARGINAL
Practice Address - Street 2:URB VILLA LISSETTE
Practice Address - City:GUAYNABO
Practice Address - State:PR
Practice Address - Zip Code:00969-3421
Practice Address - Country:US
Practice Address - Phone:787-999-6570
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-01
Last Update Date:2025-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty