Individual
MRS. XENIA MEDINA-ROQUE
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
DC
Contact information
Practice address
37 MENDEZ VIGO, PONCE, PR 00731
(787) 848-6539
(787) 848-6539
Mailing address
37 MENDEZ VIGO, PONCE, PR 00731
(787) 848-6539
(787) 848-6539
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
295
PR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
233007
PREFERRED
—
01
—
35105
SSS
—
01
—
5473
IMC
—
01
—
601609
MMM
—
01
—
7310384
HUMANA
—
Enumeration date
09/07/2005
Last updated
07/08/2007
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