Provider Demographics
NPI:1760873475
Name:BQG CORP
Entity Type:Organization
Organization Name:BQG CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:
Authorized Official - First Name:THAIS
Authorized Official - Middle Name:
Authorized Official - Last Name:BERMUDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:787-306-4472
Mailing Address - Street 1:PO BOX 11991
Mailing Address - Street 2:CAPARRA HEIGHT STATION
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00922-1991
Mailing Address - Country:US
Mailing Address - Phone:787-919-7505
Mailing Address - Fax:
Practice Address - Street 1:490 CALLE SIRIO
Practice Address - Street 2:URB. ALTAMIRA
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00920
Practice Address - Country:US
Practice Address - Phone:787-919-7505
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-17
Last Update Date:2015-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty