Provider Demographics
NPI:1467224972
Name:QUIROPLAZA TRUJILLO ALTO LLC
Entity Type:Organization
Organization Name:QUIROPLAZA TRUJILLO ALTO LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LUIS
Authorized Official - Middle Name:B
Authorized Official - Last Name:RIVERA NAZARIO
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:787-233-1001
Mailing Address - Street 1:PO BOX 1560
Mailing Address - Street 2:
Mailing Address - City:TRUJILLO ALTO
Mailing Address - State:PR
Mailing Address - Zip Code:00977-1560
Mailing Address - Country:US
Mailing Address - Phone:787-425-0878
Mailing Address - Fax:
Practice Address - Street 1:PLAZA ENCANTADA
Practice Address - Street 2:PR 181 FINAL SUITE C7
Practice Address - City:TRUJILLO ALTO
Practice Address - State:PR
Practice Address - Zip Code:00976
Practice Address - Country:US
Practice Address - Phone:787-425-0878
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-27
Last Update Date:2023-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty