Centro Quiropractico de Vega Alta LLC

Organization Active NPI Chiropractor · Vega Alta, PR

NPI 1548042872 · NPPES record last updated May 31, 2024

Key facts

NPI
1548042872
Entity type
Organization (NPI type 2)
Primary specialty
Chiropractor 111N00000X
Legal business name
CENTRO QUIROPRACTICO DE VEGA ALTA LLC
Practice address
2 Calle 1
Vega Alta, PR 00692-7113
Phone
(787) 245-4936
NPI assigned
Oct 20, 2023
Organization subpart
No

Authorized official

Name
Dr. Jose Carlos Maysonet Acevedo, DC
Title
Owner
Phone
(787) 994-9330

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in PR

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20240620003579 PR Part B Supplier - Clinic/Group Practice 5193268951 Receives reassigned benefits from 1 practitioner
Practice locations: Vega Alta, PR

National Provider Directory

Locations

2 Calle 1
Vega Alta, PR 00692
Phone (787) 245-4936

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor
Group: 193400000X SINGLE SPECIALTY GROUP
111N00000X Yes

Addresses

Primary practice location

2 Calle 1
Vega Alta, PR 00692-7113

Mailing address

N11 Calle 9
Vega Alta, PR 00692-6010
Phone (787) 994-9330

Other identifiers

IdentifierTypeStateIssuer
039624600MedicaidPR

Electronic endpoints

TypeEndpointUseAffiliation
Direct Messaging Address dcmaysonet@outlook.com Direct

Other providers in Vega Alta, PR

All providers in Vega Alta, PR · Chiropractor in Puerto Rico

Sources for this page

Verify at the official NPI Registry.