Provider Demographics
NPI:1215197363
Name:CARRERAS RODRIGUEZ, JOHN ERIC (DC)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:ERIC
Last Name:CARRERAS RODRIGUEZ
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:C/24 AA-3
Mailing Address - Street 2:URB. FLAMBOYAN GARDENS
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00959-5803
Mailing Address - Country:US
Mailing Address - Phone:787-395-7555
Mailing Address - Fax:787-395-7556
Practice Address - Street 1:C/24 AA-3
Practice Address - Street 2:URB. FLAMBOYAN GARDENS
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00959-5803
Practice Address - Country:US
Practice Address - Phone:787-395-7555
Practice Address - Fax:787-395-7556
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-12
Last Update Date:2017-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR434111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor