Active NPI
Antonio Alberto Vivaldi, MD
- General Practice Physician
- Mayaguez, PR
National Provider Identifier
1104995976
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Physician
- License
- 12740
- Practice address
- Calle Post 509 Sur
Mayaguez, PR 00680 - Phone
- (787) 833-7650
- Fax
- (787) 265-3310
- NPI assigned
- Nov 7, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Physician | 208D00000X | 12740 | PR | Primary |
Addresses
Primary practice location
Calle Post 509 Sur
Mayaguez, PR 00680
Mailing address
PO Box 726
Mayaguez, PR 00681-0726
Phone (787) 851-8606
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12740 | PR | MD | General Practice Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162857600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1104995976",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 726",
"city": "MAYAGUEZ",
"state": "PR",
"postal_code": "006810726",
"telephone_number": "787-851-8606"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "CALLE POST 509 SUR",
"city": "MAYAGUEZ",
"state": "PR",
"postal_code": "00680",
"telephone_number": "787-833-7650",
"fax_number": "787-265-3310"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VIVALDI",
"first_name": "ANTONIO",
"middle_name": "ALBERTO",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-11-07",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "208D00000X",
"taxonomy_group": "",
"desc": "General Practice",
"state": "PR",
"license": "12740",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mayaguez, PR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.