Provider Demographics
NPI:1679209415
Name:ACUPRACTICO LLC
Entity Type:Organization
Organization Name:ACUPRACTICO LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JUAN
Authorized Official - Middle Name:ESTEBAN
Authorized Official - Last Name:LUGO RODRIGUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:DC, LAC,MSAOM
Authorized Official - Phone:787-400-1081
Mailing Address - Street 1:LA RAMBLA 911 CALLE ZARAGOZA
Mailing Address - Street 2:
Mailing Address - City:PONCE
Mailing Address - State:PR
Mailing Address - Zip Code:00730-4022
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:CALLE NUBE C10
Practice Address - Street 2:URB BELLA VISTA
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00716
Practice Address - Country:US
Practice Address - Phone:787-239-9987
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-25
Last Update Date:2023-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR1447737770Medicaid