Jonathan L Becerra Lopez, DC
Individual provider Active NPI Chiropractor · Coamo, PR
NPI 1487416616 · NPPES record last updated Dec 3, 2024
Key facts
- NPI
- 1487416616
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Chiropractor 111N00000X
- License
- 4913 (SC)
- Practice address
- 40 Calle Florencio Santiago
Coamo, PR 00769-3208 - Phone
- (787) 648-1863
- NPI assigned
- Jan 24, 2024
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in SC, PR
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240515003622 | SC | Practitioner - Chiropractic | 2365883790 | |
| I20241231001773 | PR | Practitioner - Chiropractic | 2365883790 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 963 | PR | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Quest Chiropractic LLC | Chiropractor | Current |
Accepting new patients |
| Maxima Chiropractic Clinic | Chiropractor | Current |
Accepting new patients |
Locations
40 Calle Florencio Santiago
Coamo, PR 00769
Phone (787) 648-1863
8 W Lewis Plz
Greenville, SC 29605
Phone (864) 263-3020
8 W Lewis Plz
#8
Greenville, SC 29605
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 4913 | SC | Yes |
Addresses
Primary practice location
40 Calle Florencio Santiago
Coamo, PR 00769-3208
Mailing address
Ext Jard de Coamo
Calle 13 F2
Coamo, PR 00769
Phone (787) 648-1863
Other providers in Coamo, PR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 3, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.