Provider Demographics
NPI:1376903914
Name:SAN JORGE CHIROPRACTIC SERVICES
Entity Type:Organization
Organization Name:SAN JORGE CHIROPRACTIC SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDIT MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:AMAIRA
Authorized Official - Middle Name:
Authorized Official - Last Name:NIEVES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-727-1000
Mailing Address - Street 1:COND SAN JORGE
Mailing Address - Street 2:252
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00912-3302
Mailing Address - Country:US
Mailing Address - Phone:787-727-1000
Mailing Address - Fax:787-727-3610
Practice Address - Street 1:253 CALLE SAN JORGE
Practice Address - Street 2:SAN JORGE CORPORATE BUILDING 2B
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00912
Practice Address - Country:US
Practice Address - Phone:787-727-1000
Practice Address - Fax:787-268-3610
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SAN JORGE CHILDREN'S HOSPITAL, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-02-24
Last Update Date:2016-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR64282NC2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NC2000XHospitalsGeneral Acute Care HospitalChildren