Provider Demographics
NPI:1093500969
Name:LOPEZ-BORRERO, JUAN ABDIEL (DC, BS)
Entity type:Individual
Prefix:DR
First Name:JUAN
Middle Name:ABDIEL
Last Name:LOPEZ-BORRERO
Suffix:
Gender:
Credentials:DC, BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 420
Mailing Address - Street 2:
Mailing Address - City:ANASCO
Mailing Address - State:PR
Mailing Address - Zip Code:00610-0420
Mailing Address - Country:US
Mailing Address - Phone:787-394-3542
Mailing Address - Fax:
Practice Address - Street 1:CALLE 65 INFANTERIA, ESQUINA MARIA MONAGAS #107
Practice Address - Street 2:
Practice Address - City:ANASCO
Practice Address - State:PR
Practice Address - Zip Code:00610
Practice Address - Country:US
Practice Address - Phone:787-394-3542
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-11
Last Update Date:2025-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1013111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR1013OtherCHIROPRACTIC LICENSE