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General NPI Number Information
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NPI Number | 1578283271
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Entity Type | Individual
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Provider Name | MIGUEL ANTONIO BERTRAN DC
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Gender | Male
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Dates
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Enumeration Date | 09/01/2022
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Last Update Date | 09/01/2022
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Provider Practice Location Address
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Address Line | 69 CALLE REINA BEATRIZ
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City | GUAYNABO
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State | PR
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Zip | 00969-3272
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Country | US
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Telephone | 787-429-0411
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Fax |
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Provider Business Mailing Address
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Address Line | 1353 LUIS VIGOREAUX AVE. PMB 870
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City | GUAYNABO
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State | PR
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Zip | 00966
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Country | US
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Telephone | 787-429-0411
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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 | 849
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License Number State | PR
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