P.R. Med Vitality LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

P.R. MED VITALITY LLC

Practice address

3 Calle Jardines
Hormigueros, PR 00660-1733

Phone

(939) 299-0112

NPI assigned

Nov 6, 2023

Organization subpart

No

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

Authorized official

Name

Jennifer Suris Cancel, MDNPI 1730645565

Title

Sole MBR

Phone

(939) 299-0113

Specialties & licenses 1

Addresses

Other names 1

• P.R. Med Vitality LLC Former legal business name

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jennifer Suris Cancel, MD

  • Family Medicine Physician
  • Hormigueros, PR
  • NPI 1730645565
  NPD Authorized official

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

{
    "created_epoch": "1699228800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1699228800000",
    "number": "1194598623",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "URBANIZACION REMANSO CALLE BAYA HONDA 1020",
            "city": "CABO ROJO",
            "state": "PR",
            "postal_code": "00623",
            "telephone_number": "939-299-0112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 CALLE JARDINES",
            "city": "HORMIGUEROS",
            "state": "PR",
            "postal_code": "006601733",
            "telephone_number": "939-299-0112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "P.R. MED VITALITY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-11-06",
        "last_updated": "2023-11-06",
        "certification_date": "2023-11-04",
        "status": "A",
        "authorized_official_last_name": "SURIS CANCEL",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "SOLE MBR",
        "authorized_official_telephone_number": "939-299-0113",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "P.R. Med Vitality LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Line Ivette Ocasio
• Ocpr LLC
• Optica la Monserrate
• Nancy Ortiz-Camacho, LND
• Krystal Ortiz II, LCSW
• Ada M. Padro, PSYCHOLOGIST
• Guillermo A Pagan Calo, M.D.
• Carlos M Pagan Monsegur, CPHT
• Albit Rafael Paoli, DDS
• Elizabeth Peluyera Valentin

• Family Medicine Physician in Hormigueros, PR
• Providers in Hormigueros, PR by specialty
• Family Medicine Physician in Puerto Rico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2023; 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.