Advance Chiropractic and Laser Clinic LLC
Organization Active NPI Chiropractor · Carolina, PR
NPI 1629699467 · NPPES record last updated May 4, 2020
Key facts
- NPI
- 1629699467
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Chiropractor 111N00000X
- Legal business name
- ADVANCE CHIROPRACTIC AND LASER CLINIC LLC
- Practice address
- 4Es4 Via Leticia
Carolina, PR 00983-4807 - Phone
- (787) 257-5200
- NPI assigned
- May 4, 2020
- Organization subpart
- No
Authorized official
- Name
- Dr. Victor M Cruz, DC
- Title
- Clinic Director
- Phone
- (787) 344-6695
Practitioners 2
-
Victor Manuel Cruz, D.C.
-
John M Gonzalez, DC
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in PR
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20230516002426 | PR | Part B Supplier - Clinic/Group Practice | 3274999305 |
Receives reassigned benefits from 2 practitioners Practice locations: Carolina, PR |
National Provider Directory
Locations
4ES4 Via Leticia
Carolina, PR 00983
Phone (787) 257-5200
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor |
111N00000X | Yes |
Addresses
Primary practice location
4Es4 Via Leticia
Carolina, PR 00983-4807
Mailing address
BW7 113
Valle Arriba Heights
Carolina, PR 00983-3326
Phone (787) 344-6695
Other names
- Advance Chiropractic
Other providers in Carolina, PR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 4, 2020. 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.