Provider Demographics
NPI:1316474208
Name:SANCHEZ VIVALDI, CARLA MARIE (ND)
Entity type:Individual
Prefix:
First Name:CARLA
Middle Name:MARIE
Last Name:SANCHEZ VIVALDI
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:119 LOOP RD
Mailing Address - Street 2:
Mailing Address - City:AGUADILLA
Mailing Address - State:PR
Mailing Address - Zip Code:00603-1332
Mailing Address - Country:US
Mailing Address - Phone:787-458-4021
Mailing Address - Fax:
Practice Address - Street 1:60 CALLE MEDITACION
Practice Address - Street 2:
Practice Address - City:MAYAGUEZ
Practice Address - State:PR
Practice Address - Zip Code:00680-4819
Practice Address - Country:US
Practice Address - Phone:787-832-7134
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-22
Last Update Date:2017-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR48171100000X
PR048175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath
No171100000XOther Service ProvidersAcupuncturist