MEDICARE: AQ CLINICA DEL SUR LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor

General Provider Information

NPI Number	:	1164173357
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AQ CLINICA DEL SUR LLC

Provider Business Mailing Address
First Line	:	PO BOX 228
Second Line	:
City	:	SANTA ISABEL
State	:	PR
Zip	:	00757-0228
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	50 CALLE LUIS MUNOZ RIVERA
Second Line	:
City	:	SANTA ISABEL
State	:	PR
Zip	:	00757-2691
Country	:	US
Telephone Number	:	787-476-4194
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENTE, TESORERO(A)
Name	:	DR. NATALIA APONTE QUINONES
Credential	:	DC
Telephone Number	:	787-432-7707

Provider Enumeration Date	:	01/10/2022
Last Update Date	:	01/30/2025

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