MEDICARE: MIQUIROPRACTICOPR LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor

General Provider Information

NPI Number	:	1609510528
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MIQUIROPRACTICOPR LLC

Provider Business Mailing Address
First Line	:	6981 CARR 187 APT 15A
Second Line	:
City	:	CAROLINA
State	:	PR
Zip	:	00979-7057
Country	:	US
Telephone Number	:	787-667-5898
Fax Number	:

Provider Business Practice Location Address
First Line	:	1665 AVE VCTR LABIOSA STE 106
Second Line	:
City	:	SAN JUAN
State	:	PR
Zip	:	00926-4149
Country	:	US
Telephone Number	:	787-223-9160
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. JULIE S MARTINEZ
Credential	:
Telephone Number	:	787-667-5711

Provider Enumeration Date	:	04/26/2022
Last Update Date	:	04/26/2022

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Directions to “MIQUIROPRACTICOPR LLC ” Practice Location

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