Immanis Dignus LLC
Organization Active NPI Chiropractor · Rincon, PR
NPI 1790521565 · NPPES record last updated Jul 2, 2024
Key facts
- NPI
- 1790521565
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Chiropractor 111N00000X
- Legal business name
- IMMANIS DIGNUS LLC
- Practice address
- Carr 115 Bo Calvache KM 14.1
Local 4
Rincon, PR 00677 - Phone
- (787) 456-6444
- NPI assigned
- Jul 2, 2024
- Organization subpart
- No
Authorized official
- Name
- Maylin Aixa Garcia Lopez, DC
- Title
- President
- Phone
- (787) 427-8313
Practitioners 3
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in PR
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20241101003409 | PR | Part B Supplier - Clinic/Group Practice | 0941733612 |
Receives reassigned benefits from 3 practitioners Practice locations: Rincon, PR |
National Provider Directory
Locations
110 Ave 21 de Diciembre
Sabana Grande, PR 00637
Phone (787) 873-3222
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor |
111N00000X | Yes |
Addresses
Primary practice location
Carr 115 Bo Calvache KM 14.1
Local 4
Rincon, PR 00677
Mailing address
HC 57 Box 9702
Aguada, PR 00602-9715
Phone (787) 427-8313
Other practice location 1
110 Ave 21 De Diciembre
Sabana Grande, PR 00637-1982
Phone (939) 438-5621
Other providers in Rincon, PR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 2, 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.