Provider Demographics
NPI:1528794344
Name:AFL CHIROPRACTIC
Entity type:Organization
Organization Name:AFL CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE MBR
Authorized Official - Prefix:
Authorized Official - First Name:ANDRES
Authorized Official - Middle Name:
Authorized Official - Last Name:FUENTES LAZZARINI
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:787-240-3672
Mailing Address - Street 1:C28 CALLE 4
Mailing Address - Street 2:
Mailing Address - City:ISABELA
Mailing Address - State:PR
Mailing Address - Zip Code:00662-3835
Mailing Address - Country:US
Mailing Address - Phone:787-240-3672
Mailing Address - Fax:
Practice Address - Street 1:CARR. 112 KM 2.8 BO. GUERRERO
Practice Address - Street 2:
Practice Address - City:ISABELA
Practice Address - State:PR
Practice Address - Zip Code:00662
Practice Address - Country:US
Practice Address - Phone:787-932-2957
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-25
Last Update Date:2022-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty