Provider Demographics
NPI:1730931577
Name:PESANTE, JONATHAN JOEL (DC)
Entity type:Individual
Prefix:DR
First Name:JONATHAN
Middle Name:JOEL
Last Name:PESANTE
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:PO BOX 13
Mailing Address - Street 2:
Mailing Address - City:MAYAGUEZ
Mailing Address - State:PR
Mailing Address - Zip Code:00681-0013
Mailing Address - Country:US
Mailing Address - Phone:787-425-3446
Mailing Address - Fax:
Practice Address - Street 1:901 AVE STA TERESA JOURNET STE 2
Practice Address - Street 2:
Practice Address - City:MAYAGUEZ
Practice Address - State:PR
Practice Address - Zip Code:00682-1211
Practice Address - Country:US
Practice Address - Phone:787-538-5460
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-04
Last Update Date:2025-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR984111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor