Healthcare Provider Details

I. General information

NPI: 1952249534
Provider Name (Legal Business Name): CONEQTIV QUIROPRACTICO LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/24/2026
Last Update Date: 03/24/2026
Certification Date: 03/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

I1 AVE BETANCES
BAYAMON PR
00959-5257
US

IV. Provider business mailing address

484 CALLE PIRAGUA BRISAS DE MONTECASINO
TOA ALTA PR
00953-3836
US

V. Phone/Fax

Practice location:
  • Phone: 939-376-0620
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State

VIII. Authorized Official

Name: JAVIER ANTONIO CRUZ ORTIZ
Title or Position: CHIEF EXECUTIVE MANAGER
Credential: DC
Phone: 787-349-6904