Healthcare Provider Details
I. General information
NPI: 1508720772
Provider Name (Legal Business Name): PRO ACTIVE CHIROPRACTIC & WELLNESS
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 12/12/2025
Last Update Date: 12/12/2025
Certification Date: 12/12/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
C3 CALLE MARGINAL
DORADO PR
00646-2057
US
IV. Provider business mailing address
C3 CALLE MARGINAL
DORADO PR
00646-2057
US
V. Phone/Fax
- Phone: 939-396-0596
- Fax:
- Phone: 939-396-0596
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 111N00000X |
| Taxonomy | Chiropractor |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
GIOVANNA
RAMIREZ
Title or Position: PRESIDENT
Credential: DC
Phone: 787-202-3212