Provider Demographics
NPI:1801408489
Name:VACCINES & VITAMINS WELLNESS CENTER
Entity type:Organization
Organization Name:VACCINES & VITAMINS WELLNESS CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRADORA
Authorized Official - Prefix:
Authorized Official - First Name:DANIA
Authorized Official - Middle Name:L
Authorized Official - Last Name:COLON ALVARADO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-432-7090
Mailing Address - Street 1:936 DOLORES P MARCHAND
Mailing Address - Street 2:URB VILLAS DE RIO CANAS
Mailing Address - City:PONCE
Mailing Address - State:PR
Mailing Address - Zip Code:00728-1928
Mailing Address - Country:US
Mailing Address - Phone:787-944-5632
Mailing Address - Fax:
Practice Address - Street 1:293 AVE WINSTON CHURCHILL
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00926-6604
Practice Address - Country:US
Practice Address - Phone:787-944-5632
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-17
Last Update Date:2020-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center