Provider Demographics
NPI:1386892933
Name:VITA HEALTHCARE INC
Entity type:Organization
Organization Name:VITA HEALTHCARE INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO-PRESIDENTE
Authorized Official - Prefix:
Authorized Official - First Name:JUAN
Authorized Official - Middle Name:L
Authorized Official - Last Name:SALGADO
Authorized Official - Suffix:
Authorized Official - Credentials:MD- FACOG
Authorized Official - Phone:787-723-8482
Mailing Address - Street 1:PO BOX 8310
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00910-0310
Mailing Address - Country:US
Mailing Address - Phone:787-723-8482
Mailing Address - Fax:209-205-9499
Practice Address - Street 1:VITA HEALTHCARE INC
Practice Address - Street 2:607A CALLE DEL PARQUE
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00909-2307
Practice Address - Country:US
Practice Address - Phone:787-723-8482
Practice Address - Fax:209-205-9499
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-08
Last Update Date:2021-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251E00000XAgenciesHome Health
No207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR038484300Medicaid