Provider Demographics
NPI:1427825314
Name:CHIQUIRIMUNDI MEDICAL LLC
Entity type:Organization
Organization Name:CHIQUIRIMUNDI MEDICAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JEANETTE
Authorized Official - Middle Name:V
Authorized Official - Last Name:TORRES SERRANT
Authorized Official - Suffix:
Authorized Official - Credentials:CCC-SLP
Authorized Official - Phone:787-844-4628
Mailing Address - Street 1:2190 PONCE BY PASS
Mailing Address - Street 2:URB INDUSTRIAL REPARADA
Mailing Address - City:PONCE
Mailing Address - State:PR
Mailing Address - Zip Code:00717
Mailing Address - Country:US
Mailing Address - Phone:787-844-4628
Mailing Address - Fax:
Practice Address - Street 1:URB INDUSTRIAL REPARADA
Practice Address - Street 2:2188 LOCAL A SUITE A PONCE BY PASS
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00716
Practice Address - Country:US
Practice Address - Phone:787-844-4628
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-11
Last Update Date:2023-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty