Provider Demographics
NPI:1841473360
Name:BOZZO, JOSE RAFAEL (DC)
Entity type:Individual
Prefix:DR
First Name:JOSE
Middle Name:RAFAEL
Last Name:BOZZO
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 1:64 CALLE MATTEI LLUBERAS
Mailing Address - Street 2:
Mailing Address - City:YAUCO
Mailing Address - State:PR
Mailing Address - Zip Code:00698-3632
Mailing Address - Country:US
Mailing Address - Phone:787-267-2444
Mailing Address - Fax:787-267-2444
Practice Address - Street 1:64 CALLE MATTEI LLUBERAS
Practice Address - Street 2:
Practice Address - City:YAUCO
Practice Address - State:PR
Practice Address - Zip Code:00698-3632
Practice Address - Country:US
Practice Address - Phone:787-267-2444
Practice Address - Fax:787-267-2444
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-06
Last Update Date:2008-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR412111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor