# CENVAC CORPORATION

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Centro Vacunacion Familiar Vida
- **Organization subpart:** No

## Provider details

- **NPI number:** 1104399799
- **Authorized official:** MISS NORIANN RIVERA (ADMINISTRATOR)
- **Authorized official phone:** (347) 673-3037

## Contact information

- **Practice address:** N26 URB TOA ALTA HEIGHTS, AVENIDA PRINCIPAL OFC 1, TOA ALTA, PR 00953
- **Practice address phone:** (347) 673-3037
- **Mailing address:** 229 VILLA CAPARRA EXECUTIVE, CARRETERA 2 APT 1H, GUAYNABO, PR 00966

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261Q00000X | Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 01/07/2019
- **Last updated:** 01/07/2019