Healthcare Provider Details

I. General information

NPI: 1083518237
Provider Name (Legal Business Name): AJUSTATEPR LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/02/2026
Last Update Date: 10/02/2026
Certification Date: 09/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CARRETERA 116 KM. 27.7
GUANICA PR
00653
US

IV. Provider business mailing address

HC 38 BOX 8117
GUANICA PR
00653-8837
US

V. Phone/Fax

Practice location:
  • Phone: 787-232-5474
  • Fax:
Mailing address:
  • Phone: 787-233-5474
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: DAVIDLEE LOPEZ TARDI
Title or Position: OWNER
Credential: DC
Phone: 787-232-5474