Pura Vita

Primary specialty

Health Service Clinic/CenterTaxonomy code 261QH0100X

Legal business name

PURA VITA

Doing business as

Pura Vita

Practice address

109 Ave Dr Susoni
Hatillo, PR 00659-1955

Phone

(787) 356-2384

NPI assigned

Mar 20, 2024

Organization subpart

No

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

Authorized official

Name

Carolyne F Delgado

Title

Administrator

Phone

(787) 356-2384

Specialties & licenses 1

Addresses

Other names 1

• Pura Vita Doing business as

Medicare fee-for-service enrollment

Enrolled in PR

Enrollment records 1

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

{
    "created_epoch": "1710892800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1731974400000",
    "number": "1740040575",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "57 CALLE LAURELES",
            "city": "CAMUY",
            "state": "PR",
            "postal_code": "006279554",
            "telephone_number": "787-356-2384"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 AVE DR SUSONI",
            "city": "HATILLO",
            "state": "PR",
            "postal_code": "006591955",
            "telephone_number": "787-356-2384"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PURA VITA",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-03-20",
        "last_updated": "2024-11-19",
        "certification_date": "2024-11-19",
        "status": "A",
        "authorized_official_last_name": "DELGADO",
        "authorized_official_first_name": "CAROLYNE",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "787-356-2384"
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pura Vita",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Pura Vita",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Programa Medico del Norte, Inc.
• Proyecto Libelula LLC
• Puerto Rico Ambulance Inc
• Puerto Rico Cardiology LLC
• Pura Vida Group L.L.C.
• Stephanie Quiles Villanueva, PSYD
• Gladys Quiles, M.D.
• Karen Tatiana Quintana Ruiz, PTA
• Rafael Perez Molina
• Enoc Ramirez Legarretta

• Health Service Clinic/Center in Hatillo, PR
• Providers in Hatillo, PR by specialty
• Health Service Clinic/Center in Puerto Rico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2024; 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.