Provider Demographics
NPI:1063047132
Name:PUERTO RICO UPPER CERVICAL
Entity type:Organization
Organization Name:PUERTO RICO UPPER CERVICAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:GILMARIE
Authorized Official - Middle Name:
Authorized Official - Last Name:GUZMAN NEGRON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:939-319-5147
Mailing Address - Street 1:CALLE 8 A1 URB. SYLVIA
Mailing Address - Street 2:
Mailing Address - City:COROZAL
Mailing Address - State:PR
Mailing Address - Zip Code:00783
Mailing Address - Country:US
Mailing Address - Phone:939-319-5147
Mailing Address - Fax:
Practice Address - Street 1:COROZAL SHOPPING VILLAGE, SUITE 1-A, URB. LOMA LINDA,
Practice Address - Street 2:CARR. 159, KM 13.2
Practice Address - City:COROZAL
Practice Address - State:PR
Practice Address - Zip Code:00783
Practice Address - Country:US
Practice Address - Phone:939-319-1596
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-09
Last Update Date:2023-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty