Healthcare Provider Details

I. General information

NPI: 1619780988
Provider Name (Legal Business Name): BACK2HEALTHDOC LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/29/2025
Last Update Date: 01/29/2025
Certification Date: 01/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

48 CALLE BETANCES
CAGUAS PR
00725-3573
US

IV. Provider business mailing address

414 CALLE DUAY
SAN JUAN PR
00920-3714
US

V. Phone/Fax

Practice location:
  • Phone: 787-367-6525
  • Fax:
Mailing address:
  • Phone: 787-367-6525
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. HECTOR J. TORRES PASSALACQUA
Title or Position: DOCTOR
Credential: DC
Phone: 787-367-6525