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General NPI Number Information
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NPI Number | 1215606801
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Entity Type | Organization
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Legal Business Name | QUIROPLAZA LLC
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Dates
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Enumeration Date | 09/08/2021
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Last Update Date | 09/08/2021
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Provider Practice Location Address
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Address Line | 525 AVE FD ROOSEVELT, OFIC 805 LA TORRE DE PLAZA LAS AMERICAS
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City | SAN JUAN
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State | PR
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Zip | 00918
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Country | US
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Telephone | 787-294-2600
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Fax | 787-294-2900
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Provider Business Mailing Address
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Address Line | PO BOX 1560
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City | TRUJILLO ALTO
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State | PR
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Zip | 00977-1560
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Country | US
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Telephone | 787-294-2600
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Fax | 787-294-2900
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. LUIS B RIVERA
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Credential | DC
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Telephone | 787-294-2600
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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 |
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License Number State |
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