Organization Active NPI

Vacuvida LLC

  • Health Service Clinic/Center
  • Yauco, PR
National Provider Identifier
1689267213
Registry record updated May 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health Service Clinic/CenterTaxonomy code 261QH0100X
Legal business name
VACUVIDA LLC
Practice address
C&C Profesional Plaza
Carr 335 KM 1.5 Local 3
Yauco, PR 00698
Phone
(787) 543-1482
NPI assigned
Feb 15, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 20, 2021

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

Authorized official

Name
Eric H Quirindongo
Title
Administrator
Phone
(787) 543-1482

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X
Health Service Clinic/Center 261QH0100X Primary
Infusion Therapy Clinic/Center 261QI0500X
State or Local Public Health Clinic/Center 261QP0905X

Addresses

Primary practice location

C&C Profesional Plaza
Carr 335 KM 1.5 Local 3
Yauco, PR 00698

Mailing address

Urb Hacienda Florida Calle Jazmin #695
Yauco, PR 00698
Phone (787) 237-8623

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240921000236 PR Part B Supplier - Mass Immunization (Roster Biller Only) 2163819087 Practice locations: Yauco, PR

National Provider Directory

National Provider Directory

Locations

100 Blvd Jimmy Torres
Yauco, PR 00698
Phone (787) 718-7050

NPI Registry JSON

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

{
    "created_epoch": "1613347200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1621468800000",
    "number": "1689267213",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "URB HACIENDA FLORIDA CALLE JAZMIN #695",
            "city": "YAUCO",
            "state": "PR",
            "postal_code": "00698",
            "telephone_number": "787-237-8623"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "C&C PROFESIONAL PLAZA",
            "address_2": "CARR 335 KM 1.5 LOCAL 3",
            "city": "YAUCO",
            "state": "PR",
            "postal_code": "00698",
            "telephone_number": "787-543-1482"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VACUVIDA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-02-15",
        "last_updated": "2021-05-20",
        "certification_date": "2021-05-04",
        "status": "A",
        "authorized_official_last_name": "QUIRINDONGO",
        "authorized_official_first_name": "ERIC",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "787-543-1482"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QI0500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Infusion Therapy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QP0905X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Public Health, State or Local",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Yauco, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2021; 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.