Basic Information
| Provider Information | |||||||||
| NPI: | 1609532050 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | HEALTH CHIROPRACTIC CAGUAS, LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 1623 | ||||||||
| Address2: | |||||||||
| City: | CANOVANAS | ||||||||
| State: | PR | ||||||||
| PostalCode: | 007291623 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7872215228 | ||||||||
| FaxNumber: | 7879614864 | ||||||||
| Practice Location | |||||||||
| Address1: | #1 CALLE FOMENTO SUITE #240 | ||||||||
| Address2: | |||||||||
| City: | CAGUAS | ||||||||
| State: | PR | ||||||||
| PostalCode: | 00725 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7872215228 | ||||||||
| FaxNumber: | 7879614864 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/10/2021 | ||||||||
| LastUpdateDate: | 11/10/2021 | ||||||||
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| AuthorizedOfficialLastName: | JARROT SIERRA | ||||||||
| AuthorizedOfficialFirstName: | JORGE | ||||||||
| AuthorizedOfficialMiddleName: | R | ||||||||
| AuthorizedOfficialTitleorPosition: | CHIROPRACTOR | ||||||||
| AuthorizedOfficialTelephone: | 7876307766 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
| AuthorizedOfficialNameSuffix: | SR. | ||||||||
| AuthorizedOfficialCredential: | MD | ||||||||
| NPICertificationDate: | 10/27/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 111N00000X | Y | 193400000X SINGLE SPECIALTY GROUP | Chiropractic Providers | Chiropractor |
No ID Information.