Healthcare Provider Details

I. General information

NPI: 1659770352
Provider Name (Legal Business Name): ALEXANDRA M PEDROZA DC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/19/2014
Last Update Date: 08/19/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2 CALLE HORTENSIA COND. SKY TOWER II #5F
SAN JUAN PR
00926-6439
US

IV. Provider business mailing address

#2 CALLE HORTENCIA COND. SKY TOWER II #5F
SAN JUAN PR
00926
US

V. Phone/Fax

Practice location:
  • Phone: 787-424-8625
  • Fax: 787-781-5030
Mailing address:
  • Phone: 787-781-1831
  • Fax: 787-781-5030

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NN1001X
TaxonomyNutrition Chiropractor
License Number532
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: