Healthcare Provider Details

I. General information

NPI: 1992600183
Provider Name (Legal Business Name): RENOVA CHIROPRACTIC LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/09/2026
Last Update Date: 10/09/2026
Certification Date: 10/09/2026
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 Number
License Number StateNULL

VIII. Authorized Official

Name: DR. LISMARI ORTIZ QUINONES
Title or Position: PRESIDENT
Credential: DC
Phone: 787-237-7400