Provider Demographics
NPI:1093591166
Name:CARABALLO-VELEZ, ADA EILLEEN (DC)
Entity Type:Individual
Prefix:DR
First Name:ADA
Middle Name:EILLEEN
Last Name:CARABALLO-VELEZ
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 PASEO CIELO Y MAR
Mailing Address - Street 2:
Mailing Address - City:PENUELAS
Mailing Address - State:PR
Mailing Address - Zip Code:00624-9754
Mailing Address - Country:US
Mailing Address - Phone:404-409-9545
Mailing Address - Fax:
Practice Address - Street 1:CALLE PACHECO #20 SUITE 4A
Practice Address - Street 2:
Practice Address - City:YAUCO
Practice Address - State:PR
Practice Address - Zip Code:00698
Practice Address - Country:US
Practice Address - Phone:787-267-7000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-05
Last Update Date:2023-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR931111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor