Healthcare Provider Details

I. General information

NPI: 1588589824
Provider Name (Legal Business Name): FORTIS CORE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/13/2026
Last Update Date: 08/13/2026
Certification Date: 08/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

BO. PLAYA, CALLE SALMON #5
PONCE PR
00716
US

IV. Provider business mailing address

111 BRISAS DEL CARIBE
PONCE PR
00728-5304
US

V. Phone/Fax

Practice location:
  • Phone: 787-662-9146
  • Fax:
Mailing address:
  • Phone: 787-662-9146
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: JE TEM PINA TORRES
Title or Position: ADMINISTRATOR
Credential: DC
Phone: 787-662-9146