Healthcare Provider Details

I. General information

NPI: 1578490389
Provider Name (Legal Business Name): CLINICA QUIROPRACTICA ATLETICA Y REGENERATICA LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/06/2026
Last Update Date: 05/08/2026
Certification Date: 05/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

E3 CALLE PRINCIPAL
FAJARDO PR
00738-3762
US

IV. Provider business mailing address

61 URB CAMINO REAL
CAGUAS PR
00727-9357
US

V. Phone/Fax

Practice location:
  • Phone: 787-738-2942
  • Fax:
Mailing address:
  • Phone: 407-364-4798
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: DR. ERIC MANUEL CASTRODAD SANTINI
Title or Position: OWNER
Credential: DC
Phone: 407-364-4798