Provider Demographics
NPI:1871732552
Name:EVOLUTIONS CHIROPRACTIC, PSC
Entity type:Organization
Organization Name:EVOLUTIONS CHIROPRACTIC, PSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MIGUEL
Authorized Official - Middle Name:A
Authorized Official - Last Name:SERRANO ALVAREZ
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:787-762-5991
Mailing Address - Street 1:OA3 CALLE 500
Mailing Address - Street 2:COUNTRY CLUB
Mailing Address - City:CAROLINA
Mailing Address - State:PR
Mailing Address - Zip Code:00982-1814
Mailing Address - Country:US
Mailing Address - Phone:787-762-5991
Mailing Address - Fax:
Practice Address - Street 1:OA3 CALLE 500
Practice Address - Street 2:COUNTRY CLUB
Practice Address - City:CAROLINA
Practice Address - State:PR
Practice Address - Zip Code:00982-1814
Practice Address - Country:US
Practice Address - Phone:787-762-5991
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-19
Last Update Date:2009-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR419261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service