NPIMap

Organization Active NPI

Vita Care,LLC

  • Health Service Clinic/Center
  • San Juan, PR
National Provider Identifier
1437693017
Registry record updated Oct 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health Service Clinic/CenterTaxonomy code 261QH0100X
Legal business name
VITA CARE,LLC
Practice address
350 Ave Chardon
Torre Chardon Ste.500
San Juan, PR 00918
Phone
(787) 622-3000
Fax
(787) 300-4886
NPI assigned
Dec 15, 2016
Last updated
Oct 5, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 5, 2022

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

Authorized official

Name
Marcos Aguila Sastre
Title
Executive VP Clinics
Phone
(787) 622-3000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Health Service Clinic/Center 261QH0100X NU Primary

Addresses

Primary practice location

350 Ave Chardon
Torre Chardon Ste.500
San Juan, PR 00918

Mailing address

PO Box 71114
San Juan, PR 00936-8014
Phone (787) 622-3000

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190917003696 PR Part B Supplier - Clinic/Group Practice 2264773399 Receives reassigned benefits from 15 practitioners
Practice locations: Vega Alta, PR; San Juan, PR; San German, PR; Ponce, PR; Guayama, PR; Fajardo, PR; Carolina, PR; Arecibo, PR…

National Provider Directory

National Provider Directory

Locations

10000 Ave 65 Infanteria
Ste 204
Carolina, PR 00985
Phone (787) 523-2458

Practitioners & affiliated clinicians

Practitioners 19

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1481760000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1664928000000",
    "number": "1437693017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 71114",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009368014",
            "telephone_number": "787-622-3000",
            "fax_number": "787-300-4886"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 AVE CHARDON",
            "address_2": "TORRE CHARDON STE.500",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "00918",
            "telephone_number": "787-622-3000",
            "fax_number": "787-300-4886"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VITA CARE,LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-12-15",
        "last_updated": "2022-10-05",
        "certification_date": "2022-10-05",
        "status": "A",
        "authorized_official_last_name": "AGUILA SASTRE",
        "authorized_official_first_name": "MARCOS",
        "authorized_official_title_or_position": "EXECUTIVE VP CLINICS",
        "authorized_official_telephone_number": "787-622-3000"
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": "NU",
            "license": null,
            "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 Oct 5, 2022; 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.