Healthcare Provider Details

I. General information

NPI: 1144131558
Provider Name (Legal Business Name): KEANNA ENTERPRISE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/15/2026
Last Update Date: 09/15/2026
Certification Date: 09/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2045 DR. ALBIZU CAMPOS SUITE 5
AGUADILLA PR
00603
US

IV. Provider business mailing address

HC 58 BOX 14052
AGUADA PR
00602-9906
US

V. Phone/Fax

Practice location:
  • Phone: 787-669-1458
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code111NR0400X
TaxonomyRehabilitation Chiropractor
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code111NS0005X
TaxonomySports Physician Chiropractor
License Number
License Number State

VIII. Authorized Official

Name: KEVEN CABAN
Title or Position: PRESIDENT
Credential:
Phone: 787-566-2499