Provider Demographics
NPI:1306469390
Name:VIVIRE WELLNESS
Entity type:Organization
Organization Name:VIVIRE WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:HEALTH COACH
Authorized Official - Prefix:MRS
Authorized Official - First Name:EVELYN
Authorized Official - Middle Name:
Authorized Official - Last Name:HERNANDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:CHC
Authorized Official - Phone:954-744-5367
Mailing Address - Street 1:5599 S UNIVERSITY DR STE 103
Mailing Address - Street 2:
Mailing Address - City:DAVIE
Mailing Address - State:FL
Mailing Address - Zip Code:33328-5323
Mailing Address - Country:US
Mailing Address - Phone:954-744-5367
Mailing Address - Fax:
Practice Address - Street 1:5599 S UNIVERSITY DR STE 103
Practice Address - Street 2:
Practice Address - City:DAVIE
Practice Address - State:FL
Practice Address - Zip Code:33328-5323
Practice Address - Country:US
Practice Address - Phone:954-744-5367
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-25
Last Update Date:2020-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174H00000XOther Service ProvidersHealth EducatorGroup - Multi-Specialty
No171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic TrainerGroup - Multi-Specialty
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Multi-Specialty