Biolibriumpllc

Primary specialty

Health Maintenance OrganizationTaxonomy code 302R00000X

Legal business name

BIOLIBRIUMPLLC

Practice address

1675 Polo Lake Dr E Apt 104
Wellington, FL 33414-3112

Phone

(863) 258-7986

NPI assigned

Jan 3, 2021

Organization subpart

No

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

Authorized official

Name

Itchaqueira Beatriz Fontanez Vendrell, RD/LDN

Title

Owner, Manager, Provider

Phone

(863) 258-7986

Specialties & licenses 2

Addresses

Other identifiers 2

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

{
    "created_epoch": "1609632000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1609632000000",
    "number": "1356939680",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1675 POLO LAKE DR E APT 104",
            "city": "WELLINGTON",
            "state": "FL",
            "postal_code": "334143112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1675 POLO LAKE DR E APT 104",
            "city": "WELLINGTON",
            "state": "FL",
            "postal_code": "334143112",
            "telephone_number": "863-258-7986"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BIOLIBRIUMPLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-01-03",
        "last_updated": "2021-01-03",
        "certification_date": "2021-01-03",
        "status": "A",
        "authorized_official_last_name": "FONTANEZ VENDRELL",
        "authorized_official_first_name": "ITCHAQUEIRA",
        "authorized_official_middle_name": "BEATRIZ",
        "authorized_official_title_or_position": "OWNER, MANAGER, PROVIDER",
        "authorized_official_telephone_number": "863-258-7986",
        "authorized_official_credential": "RD/LDN"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "302R00000X",
            "taxonomy_group": "",
            "desc": "Health Maintenance Organization",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "15048304",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPPES",
            "identifier": "1629664685",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Health Maintenance Organization in Wellington, FL
• Providers in Wellington, FL by specialty
• Health Maintenance Organization in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 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.