Ed Spine Clinic LLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

Legal business name

ED SPINE CLINIC LLC

Practice address

120 Calle Belt
Aguadilla, PR 00603-1106

Phone

(787) 517-4828

NPI assigned

Jun 24, 2021

Last updated

Aug 16, 2021By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Erbett Salva Diaz, DC

Title

President

Phone

(787) 517-4828

Specialties & licenses 1

Addresses

Other names 1

• ED Spine Clinic LLC Former legal business name

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Erbett Diaz Salva, D.C.

  • Chiropractor
  • Aguadilla, PR
  • NPI 1437126000
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1624492800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1629072000000",
    "number": "1326617176",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "139 CALLE R",
            "city": "AGUADILLA",
            "state": "PR",
            "postal_code": "006031409",
            "telephone_number": "787-517-4828"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 CALLE BELT",
            "city": "AGUADILLA",
            "state": "PR",
            "postal_code": "006031106",
            "telephone_number": "787-517-4828"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ED SPINE CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-06-24",
        "last_updated": "2021-08-16",
        "certification_date": "2021-08-16",
        "status": "A",
        "authorized_official_last_name": "DIAZ",
        "authorized_official_first_name": "ERBETT",
        "authorized_official_middle_name": "SALVA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "787-517-4828",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ED Spine Clinic LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• Chiropractor in Aguadilla, PR
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.