Healthcare Provider Details

I. General information

NPI: 1649174475
Provider Name (Legal Business Name): LISMARI ORTIZ QUINONES DC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/05/2026
Last Update Date: 10/05/2026
Certification Date: 10/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

42 CALLE 25 DE JULIO
GUANICA PR
00653-2712
US

IV. Provider business mailing address

HC 37 BOX 4581
GUANICA PR
00653-8447
US

V. Phone/Fax

Practice location:
  • Phone: 787-237-7400
  • Fax:
Mailing address:
  • Phone: 787-237-7400
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number1195
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: