Provider Demographics
NPI:1598930620
Name:PANIAGUA, VIRGILIO HORACIO (DC)
Entity Type:Individual
Prefix:DR
First Name:VIRGILIO
Middle Name:HORACIO
Last Name:PANIAGUA
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:74 CALLE JOSE MARTI
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00917-3102
Mailing Address - Country:US
Mailing Address - Phone:787-309-3198
Mailing Address - Fax:
Practice Address - Street 1:CALLE JOSE MARTI 74
Practice Address - Street 2:URB. FLORAL PARK
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00917-3102
Practice Address - Country:US
Practice Address - Phone:787-309-3198
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-29
Last Update Date:2008-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR437111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor