Provider Demographics
NPI:1861113946
Name:RIVERA VELAZQUEZ, ALEJANDRO J (DC)
Entity type:Individual
Prefix:DR
First Name:ALEJANDRO
Middle Name:J
Last Name:RIVERA VELAZQUEZ
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:H7 CALLE 1
Mailing Address - Street 2:ESTANCIAS DE SAN FERNANDO
Mailing Address - City:CAROLINA
Mailing Address - State:PR
Mailing Address - Zip Code:00985-5207
Mailing Address - Country:US
Mailing Address - Phone:787-248-5046
Mailing Address - Fax:
Practice Address - Street 1:SANTURCE MEDICAL MALL
Practice Address - Street 2:1801 AVE PONCE DE LEON
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00909
Practice Address - Country:US
Practice Address - Phone:787-248-5046
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-07
Last Update Date:2023-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR884111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor