Provider Demographics
NPI:1285453985
Name:IKANOS CHIROPRACTIC & WELLNESS CENTER LLC
Entity type:Organization
Organization Name:IKANOS CHIROPRACTIC & WELLNESS CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:FELIPE
Authorized Official - Middle Name:ANTONIO
Authorized Official - Last Name:PEREZ TOLEDO
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:787-224-8879
Mailing Address - Street 1:PO BOX 219
Mailing Address - Street 2:
Mailing Address - City:ANGELES
Mailing Address - State:PR
Mailing Address - Zip Code:00611
Mailing Address - Country:US
Mailing Address - Phone:787-956-7000
Mailing Address - Fax:787-956-7012
Practice Address - Street 1:CARR 129 KM 19.6 INT
Practice Address - Street 2:
Practice Address - City:LARES
Practice Address - State:PR
Practice Address - Zip Code:00669
Practice Address - Country:US
Practice Address - Phone:787-956-7000
Practice Address - Fax:787-956-7012
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-09
Last Update Date:2024-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty