Provider Demographics
NPI:1568000180
Name:CHIROSAMURAI 1 LLC
Entity Type:Organization
Organization Name:CHIROSAMURAI 1 LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:VENTURA
Authorized Official - Middle Name:M
Authorized Official - Last Name:PELUZZO
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:787-747-8500
Mailing Address - Street 1:ARBOLADA #35
Mailing Address - Street 2:LA SERRANIA
Mailing Address - City:CAGUAS
Mailing Address - State:PR
Mailing Address - Zip Code:00725
Mailing Address - Country:US
Mailing Address - Phone:787-747-8500
Mailing Address - Fax:
Practice Address - Street 1:GUASABARA CARR.1 KM 30.6
Practice Address - Street 2:
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00725-0072
Practice Address - Country:US
Practice Address - Phone:787-747-8500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-13
Last Update Date:2019-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty