Healthcare Provider Details

I. General information

NPI: 1326943473
Provider Name (Legal Business Name): LUIS RIVERA RAMOS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/09/2026
Last Update Date: 10/09/2026
Certification Date: 10/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

BO PADILLA CARR 568 KM 28 HM 7 INT
COROZAL PR
00783
US

IV. Provider business mailing address

PO BOX 264
COROZAL PR
00783-0264
US

V. Phone/Fax

Practice location:
  • Phone: 787-394-6790
  • Fax:
Mailing address:
  • Phone: 787-394-6790
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number1205
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: