Provider Demographics
NPI:1437781085
Name:BORIQ LLC
Entity Type:Organization
Organization Name:BORIQ LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:ANA
Authorized Official - Middle Name:
Authorized Official - Last Name:MOREIRA BOU
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:939-645-0359
Mailing Address - Street 1:URB. SANTIAGO IGLESIAS 1404 AVE. PAZ GRANELA
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00921
Mailing Address - Country:US
Mailing Address - Phone:787-985-0665
Mailing Address - Fax:
Practice Address - Street 1:URB. SANTIAGO IGLESIAS 1404 AVE PAZ GRANELA
Practice Address - Street 2:SUITE C1
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00921
Practice Address - Country:US
Practice Address - Phone:787-985-0665
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-11
Last Update Date:2020-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty