MEDICARE: PURA QUIROPRACTICA 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	:	1235605486
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PURA QUIROPRACTICA LLC

Provider Business Mailing Address
First Line	:	121 CALLE JOSE DE DIEGO STE 10
Second Line	:
City	:	CIDRA
State	:	PR
Zip	:	00739-3244
Country	:	US
Telephone Number	:	787-520-7377
Fax Number	:

Provider Business Practice Location Address
First Line	:	121 CALLE JOSE DE DIEGO
Second Line	:
City	:	CIDRA
State	:	PR
Zip	:	00739-3243
Country	:	US
Telephone Number	:	787-520-7377
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	ANDRICK Y. MORALES SANTIAGO
Credential	:	DC
Telephone Number	:	787-520-7377

Provider Enumeration Date	:	10/15/2018
Last Update Date	:	02/05/2026

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