Healthcare Provider Details

I. General information

NPI: 1730762436
Provider Name (Legal Business Name): CLINICA QUIROPRACTICA POSTURAS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/30/2021
Last Update Date: 06/13/2021
Certification Date: 06/13/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

AVE. SIMON MADERA PARCELAS FALU #10
SAN JUAN PR
00924
US

IV. Provider business mailing address

HC 2 BOX 14482
CAROLINA PR
00987-9719
US

V. Phone/Fax

Practice location:
  • Phone: 787-400-8832
  • Fax:
Mailing address:
  • Phone: 787-400-3437
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State

VIII. Authorized Official

Name: DR. MIGUEL ALEXIS CARBONELL
Title or Position: OWNER
Credential: DC
Phone: 787-400-8832