Healthcare Provider Details

I. General information

NPI: 1952246712
Provider Name (Legal Business Name): JOSE ROLANDO MARCANO PEREZ DC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/20/2026
Last Update Date: 04/20/2026
Certification Date: 04/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CARR. 693 KM. 12.9 SUITE 8 BO. BRENAS, SECTOR SABANA
VEGA ALTA PR
00692
US

IV. Provider business mailing address

878 CALLE RUISENOR
SAN JUAN PR
00924-3369
US

V. Phone/Fax

Practice location:
  • Phone: 787-278-7474
  • Fax:
Mailing address:
  • Phone: 787-278-7474
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number1152
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: