Provider Demographics
NPI:1104565704
Name:VITA CHIROPRACTIC L.L.C.
Entity type:Organization
Organization Name:VITA CHIROPRACTIC L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR/VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:NINOSHKA
Authorized Official - Middle Name:
Authorized Official - Last Name:TIRADO PEREZ
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:787-529-0582
Mailing Address - Street 1:URB. HNAS DAVILA J9 AVE. BETANCES
Mailing Address - Street 2:
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00959-5108
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:URB. HNAS DAVILA J9 AVE. BETANCES
Practice Address - Street 2:
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00959-5108
Practice Address - Country:US
Practice Address - Phone:787-529-0582
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-01
Last Update Date:2025-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty