Provider Demographics
NPI:1619258126
Name:SEGUI, JORGE M (DC)
Entity Type:Individual
Prefix:
First Name:JORGE
Middle Name:M
Last Name:SEGUI
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
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Mailing Address - Street 1:MONTEVERDE II
Mailing Address - Street 2:12 MARGARITA ST.
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926
Mailing Address - Country:US
Mailing Address - Phone:787-403-5328
Mailing Address - Fax:787-777-1375
Practice Address - Street 1:CALLE ANA D PEREZ MARSHAND
Practice Address - Street 2:LOTE 2 - BYPASS
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00732-7004
Practice Address - Country:US
Practice Address - Phone:787-840-0052
Practice Address - Fax:787-840-2317
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-30
Last Update Date:2017-02-20
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PR495111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRGA330AOtherMEDICARE PTAN