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General NPI Number Information
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NPI Number | 1134983976
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Entity Type | Individual
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Provider Name | JONATHAN ALEXIS PEREZ D.C
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Gender | Male
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Dates
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Enumeration Date | 02/12/2024
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Last Update Date | 05/17/2024
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Provider Practice Location Address
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Address Line | #63 W CALLE MENDEZ VIGO EDIFICIO TORRE DE HOSTOS 1D
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City | MAYAGUEZ
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State | PR
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Zip | 00680
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Country | US
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Telephone | 787-805-0707
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Fax |
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Provider Business Mailing Address
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Address Line | 511 CALLE LOS INGENIEROS
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City | MAYAGUEZ
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State | PR
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Zip | 00682-7747
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Country | US
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Telephone | 787-616-5681
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 14878
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License Number State | FL
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