Healthcare Provider Details

I. General information

NPI: 1841813987
Provider Name (Legal Business Name): ESC QUIROPRACTICOS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/23/2020
Last Update Date: 05/23/2020
Certification Date: 05/23/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1566 CALLE BORI
SAN JUAN PR
00927-6113
US

IV. Provider business mailing address

1566 CALLE BORI
SAN JUAN PR
00927-6113
US

V. Phone/Fax

Practice location:
  • Phone: 787-764-1541
  • Fax: 787-763-8012
Mailing address:
  • Phone: 787-764-1541
  • Fax: 787-763-8012

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NS0005X
TaxonomySports Physician Chiropractor
License Number
License Number State

VIII. Authorized Official

Name: DR. ELVIN JOSUE SIVERIO
Title or Position: PRESIDENT
Credential: DC
Phone: 787-613-5879