Provider Demographics
NPI:1669698056
Name:ALEJANDRO, RICHARD (DC)
Entity type:Individual
Prefix:
First Name:RICHARD
Middle Name:
Last Name:ALEJANDRO
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 1:1845 CARR 2
Mailing Address - Street 2:BAYAMON MEDICAL PLAZA SUITE 107
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00959
Mailing Address - Country:US
Mailing Address - Phone:787-785-8666
Mailing Address - Fax:787-798-5700
Practice Address - Street 1:1845 CARR #2
Practice Address - Street 2:SUITE 106 BAYAMON MEDICAL PLAZA
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00959
Practice Address - Country:US
Practice Address - Phone:787-785-8666
Practice Address - Fax:787-798-5700
Is Sole Proprietor?:No
Enumeration Date:2007-04-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR0279111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR35097Medicare ID - Type Unspecified
U35812Medicare UPIN