Provider Demographics
NPI:1982456471
Name:ALEXANDRA ACEVEDO LLC
Entity Type:Organization
Organization Name:ALEXANDRA ACEVEDO LLC
Other - Org Name:CONEXION QUIROPRACTICA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ALEXANDRA
Authorized Official - Middle Name:MARIA
Authorized Official - Last Name:ACEVEDO GUZMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:787-525-5554
Mailing Address - Street 1:C58 CALLE MARACAIBO
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926-2254
Mailing Address - Country:US
Mailing Address - Phone:787-525-5554
Mailing Address - Fax:
Practice Address - Street 1:504 AVE HOSTOS
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00918-3231
Practice Address - Country:US
Practice Address - Phone:787-525-5554
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-05
Last Update Date:2024-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty