Healthcare Provider Details

I. General information

NPI: 1194303057
Provider Name (Legal Business Name): DAILIS Y TRAVERSO-BONILLA DC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/31/2021
Last Update Date: 12/02/2025
Certification Date: 12/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 BLVD PIEL CANELA
COAMO PR
00769-3502
US

IV. Provider business mailing address

100 AVE DEL ESPIRITU SANTO
CAGUAS PR
00725-3004
US

V. Phone/Fax

Practice location:
  • Phone: 787-238-6030
  • Fax:
Mailing address:
  • Phone: 787-414-8251
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number842
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: