Provider Demographics
NPI:1063801462
Name:SALUD Y VIDA A PLENITUD, RG. INC
Entity type:Organization
Organization Name:SALUD Y VIDA A PLENITUD, RG. INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:REYNALDO
Authorized Official - Middle Name:
Authorized Official - Last Name:RIVERA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-525-3222
Mailing Address - Street 1:CALLE COCO PLUMOSO #202
Mailing Address - Street 2:BOSQUE DE LAS PALMAS
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00956
Mailing Address - Country:US
Mailing Address - Phone:787-525-3222
Mailing Address - Fax:
Practice Address - Street 1:202 CALLE COCO PLUMOROSO
Practice Address - Street 2:
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00956-9251
Practice Address - Country:US
Practice Address - Phone:787-525-3222
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-22
Last Update Date:2015-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305S00000XManaged Care OrganizationsPoint of Service