Vaccines 360 LLC

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

VACCINES 360 LLC

Practice address

Brisas de Laurel
420 Diamante Street
Ponce, PR 00780-2217

Phone

(787) 362-9116

Fax

(787) 260-6116

NPI assigned

Jun 9, 2021

Last updated

Jun 14, 2021By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Wilfredo J Perez Vargas, MD

Title

Vice-President

Phone

(787) 362-9116

Specialties & licenses 1

Addresses

Electronic endpoints 1

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1623196800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1623628800000",
    "number": "1083281927",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "BRISAS DE LAUREL",
            "address_2": "420 DIAMANTE STREET",
            "city": "COTO LAUREL",
            "state": "PR",
            "postal_code": "00780",
            "telephone_number": "787-362-9116",
            "fax_number": "787-260-6116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "BRISAS DE LAUREL",
            "address_2": "420 DIAMANTE STREET",
            "city": "PONCE",
            "state": "PR",
            "postal_code": "007802217",
            "telephone_number": "787-362-9116",
            "fax_number": "787-260-6116"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VACCINES 360 LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-06-09",
        "last_updated": "2021-06-14",
        "certification_date": "2021-06-14",
        "status": "A",
        "authorized_official_last_name": "PEREZ VARGAS",
        "authorized_official_first_name": "WILFREDO",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "VICE-PRESIDENT",
        "authorized_official_telephone_number": "787-362-9116",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "DESKTOPS",
            "affiliation": "N",
            "address_1": "BRISAS DE LAUREL",
            "address_2": "420 DIAMANTE STREET",
            "city": "COTO LAUREL",
            "state": "PR",
            "country_code": "US",
            "postal_code": "007802217",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.