Healthcare Provider Details

I. General information

NPI: 1275463424
Provider Name (Legal Business Name): REBALANCE CHIROPRACTIC LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/20/2026
Last Update Date: 05/20/2026
Certification Date: 05/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

QN4 CALLE 246
CAROLINA PR
00982-1894
US

IV. Provider business mailing address

QN4 CALLE 246
CAROLINA PR
00982-1894
US

V. Phone/Fax

Practice location:
  • Phone: 787-517-4796
  • Fax:
Mailing address:
  • Phone: 787-517-4796
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: EDUARDO JOSE RODRIGUEZ PENA
Title or Position: CHIROPRACTIC PHYSICIAN
Credential: DC
Phone: 787-517-4796