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General NPI Number Information
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NPI Number | 1770042319
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Entity Type | Individual
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Provider Name | MIGUEL ALEXIS CARBONELL DC
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Gender | Male
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Dates
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Enumeration Date | 03/13/2019
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Last Update Date | 04/09/2025
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Provider Practice Location Address
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Address Line | AVE. SIMON MADERA PARCELAS FALU, #11, EDIFICIO B, LOCAL 4
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City | SAN JUAN
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State | PR
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Zip | 00924
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Country | US
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Telephone | 787-400-3437
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Fax |
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Provider Business Mailing Address
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Address Line | HC 2 BOX 14482
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City | CAROLINA
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State | PR
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Zip | 00987-9719
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Country | US
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Telephone | 787-400-8832
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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 | 673
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License Number State | PR
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