Provider Demographics
NPI:1669622106
Name:GOMEZ VILLEGAS, ADAMARI (DC)
Entity type:Individual
Prefix:
First Name:ADAMARI
Middle Name:
Last Name:GOMEZ VILLEGAS
Suffix:
Gender:F
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:LAS VISTAS SHPG VLG STE 9
Mailing Address - Street 2:300 AVE, FELISA RINCON
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926-6088
Mailing Address - Country:US
Mailing Address - Phone:787-914-4729
Mailing Address - Fax:
Practice Address - Street 1:LAS VISTAS SHPG VLG STE 9
Practice Address - Street 2:300 AVE, FELISA RINCON
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00926-6088
Practice Address - Country:US
Practice Address - Phone:787-914-4729
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-20
Last Update Date:2014-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR442111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor