Healthcare Provider Details

I. General information

NPI: 1952818072
Provider Name (Legal Business Name): KAIROS CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/10/2018
Last Update Date: 01/10/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

LOS FRAILES CALLE D Y E SUITE 205 CARIBBEAN CINEMAS BLDG
GUAYNABO PR
00970
US

IV. Provider business mailing address

PO BOX 2136
GUAYNABO PR
00970-2136
US

V. Phone/Fax

Practice location:
  • Phone: 787-790-7855
  • Fax:
Mailing address:
  • Phone: 787-790-7855
  • Fax: 787-709-4751

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NR0400X
TaxonomyRehabilitation Chiropractor
License Number513
License Number StatePR

VIII. Authorized Official

Name: DR. EDWIN CARRILLO-SANCHEZ
Title or Position: CHIROPRACTOR
Credential: DC
Phone: 787-790-7855