=====================================================
General NPI Number Information
=====================================================
NPI Number | 1194303057
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | DAILIS Y TRAVERSO-BONILLA DC
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/31/2021
-----------------------------------------------------
Last Update Date | 12/02/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 111 BLVD PIEL CANELA
-----------------------------------------------------
City | COAMO
-----------------------------------------------------
State | PR
-----------------------------------------------------
Zip | 00769-3502
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 787-238-6030
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 100 AVE DEL ESPIRITU SANTO
-----------------------------------------------------
City | CAGUAS
-----------------------------------------------------
State | PR
-----------------------------------------------------
Zip | 00725-3004
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 787-414-8251
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 111N00000X
-----------------------------------------------------
Taxonomy Name | Chiropractor
-----------------------------------------------------
License Number | 842
-----------------------------------------------------
License Number State | PR
-----------------------------------------------------