Provider Demographics
NPI:1275284010
Name:INERVA, LLC
Entity Type:Organization
Organization Name:INERVA, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:
Authorized Official - First Name:ANTONIO
Authorized Official - Middle Name:
Authorized Official - Last Name:RODRIGUEZ PEREZ
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:787-647-9337
Mailing Address - Street 1:352 AVE SAN CLAUDIO
Mailing Address - Street 2:SUITE #377
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926
Mailing Address - Country:US
Mailing Address - Phone:787-647-9337
Mailing Address - Fax:787-561-7464
Practice Address - Street 1:PLAZA MARINA SUITE #13
Practice Address - Street 2:535 CARR. 189 KM. 6.40
Practice Address - City:GURABO
Practice Address - State:PR
Practice Address - Zip Code:00778-4202
Practice Address - Country:US
Practice Address - Phone:787-414-9898
Practice Address - Fax:787-561-7464
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-13
Last Update Date:2024-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty