Provider Demographics
NPI:1497454409
Name:EVOLUTIONS CHIROPRACTIC & REHAB
Entity Type:Organization
Organization Name:EVOLUTIONS CHIROPRACTIC & REHAB
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MIGUEL
Authorized Official - Middle Name:ANGEL
Authorized Official - Last Name:SERRANO
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:787-762-5991
Mailing Address - Street 1:PO BOX 79571
Mailing Address - Street 2:
Mailing Address - City:CAROLINA
Mailing Address - State:PR
Mailing Address - Zip Code:00984-9571
Mailing Address - Country:US
Mailing Address - Phone:787-762-5991
Mailing Address - Fax:
Practice Address - Street 1:OA3 CALLE 500
Practice Address - Street 2:
Practice Address - City:CAROLINA
Practice Address - State:PR
Practice Address - Zip Code:00982-1814
Practice Address - Country:US
Practice Address - Phone:787-762-5991
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-28
Last Update Date:2023-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty