Provider Demographics
NPI:1154905933
Name:NECO-HUERTAS, LEONARDO RENE (DC)
Entity type:Individual
Prefix:DR
First Name:LEONARDO
Middle Name:RENE
Last Name:NECO-HUERTAS
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:RR 4 BOX 3013
Mailing Address - Street 2:
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00956-9421
Mailing Address - Country:US
Mailing Address - Phone:939-592-8002
Mailing Address - Fax:
Practice Address - Street 1:CALLE 3 SOLAR 2/A
Practice Address - Street 2:URB. COLINAS DE CERRO GORDO
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00956-9421
Practice Address - Country:US
Practice Address - Phone:939-592-8002
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-08
Last Update Date:2021-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR000704111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor