Organization Active NPI

Vals Holistic Wellness LLC

  • Internal Medicine Physician
  • San Juan, PR
National Provider Identifier
1336589126
Registry record updated Jan 13, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
12616 Issued in PR
Legal business name
VALS HOLISTIC WELLNESS LLC
Practice address
Ashford Medical Ctr
29 Washington Street Suite 102
San Juan, PR 00907-1510
Phone
(787) 725-4945
Fax
(787) 725-0623
NPI assigned
Jun 26, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2015

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

Authorized official

Name
Wency Rubio Gonzalez
Title
President
Phone
(787) 725-4945

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X 12616 PR Primary

Addresses

Primary practice location

Ashford Medical Ctr
29 Washington Street Suite 102
San Juan, PR 00907-1510

Mailing address

Ashford Medical Ctr
29 Washington Street Suite 102
San Juan, PR 00907-1510
Phone (787) 725-4945

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140430002190 PR Part B Supplier - Clinic/Group Practice 4082847835 Receives reassigned benefits from 1 practitioner
Practice locations: San Juan, PR

National Provider Directory

National Provider Directory

Locations

29 Calle Washington
Ste 102
San Juan, PR 00907
Phone (787) 272-1558

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1372204800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1421107200000",
    "number": "1336589126",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "ASHFORD MEDICAL CTR",
            "address_2": "29 WASHINGTON STREET SUITE 102",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009071510",
            "telephone_number": "787-725-4945",
            "fax_number": "787-725-0623"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "ASHFORD MEDICAL CTR",
            "address_2": "29 WASHINGTON STREET SUITE 102",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009071510",
            "telephone_number": "787-725-4945",
            "fax_number": "787-725-0623"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VALS HOLISTIC WELLNESS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-06-26",
        "last_updated": "2015-01-13",
        "status": "A",
        "authorized_official_last_name": "RUBIO GONZALEZ",
        "authorized_official_first_name": "WENCY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "787-725-4945"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "PR",
            "license": "12616",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Juan, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.