Provider Demographics
NPI:1700128261
Name:CENTRO QUIROPRACTICO DR. GABRIEL ROJAS, C.S.P
Entity Type:Organization
Organization Name:CENTRO QUIROPRACTICO DR. GABRIEL ROJAS, C.S.P
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:GABRIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:ROJAS GONZALEZ
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:787-689-5401
Mailing Address - Street 1:PO BOX 142038
Mailing Address - Street 2:
Mailing Address - City:ARECIBO
Mailing Address - State:PR
Mailing Address - Zip Code:00614-2038
Mailing Address - Country:US
Mailing Address - Phone:787-689-5401
Mailing Address - Fax:787-689-5402
Practice Address - Street 1:URB. MONTE CARLO CALLE MARGINAL
Practice Address - Street 2:# 124
Practice Address - City:VEGA BAJA
Practice Address - State:PR
Practice Address - Zip Code:00693-4218
Practice Address - Country:US
Practice Address - Phone:787-689-5401
Practice Address - Fax:787-689-5402
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-22
Last Update Date:2013-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR424111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR0059598Medicare UPIN