Provider Demographics
NPI:1114641446
Name:SOLIS CRUZ, LUIS JAVIER (DC)
Entity Type:Individual
Prefix:
First Name:LUIS
Middle Name:JAVIER
Last Name:SOLIS CRUZ
Suffix:
Gender:M
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:PO BOX 1588
Mailing Address - Street 2:
Mailing Address - City:GUAYAMA
Mailing Address - State:PR
Mailing Address - Zip Code:00785-1588
Mailing Address - Country:US
Mailing Address - Phone:787-568-3630
Mailing Address - Fax:
Practice Address - Street 1:20 CALLE GENERAL BROOKE
Practice Address - Street 2:
Practice Address - City:ARROYO
Practice Address - State:PR
Practice Address - Zip Code:00714-2610
Practice Address - Country:US
Practice Address - Phone:787-839-1845
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-29
Last Update Date:2022-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR000887111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty