Healthcare Provider Details

I. General information

NPI: 1346144946
Provider Name (Legal Business Name): RAUL ANDRES FERNANDEZ DC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/06/2026
Last Update Date: 10/06/2026
Certification Date: 10/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

311 CALLE COSTA DORADA APT 88
DORADO PR
00646-1107
US

IV. Provider business mailing address

311 CALLE COSTA DORADA APT 88
DORADO PR
00646-1107
US

V. Phone/Fax

Practice location:
  • Phone: 787-514-3609
  • Fax:
Mailing address:
  • Phone: 787-514-3609
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number1180
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: