MEDICARE: TIENDA APNEA DEL SUENO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332B00000X	Durable Medical Equipment & Medical Supplies

General Provider Information

NPI Number	:	1396299251
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TIENDA APNEA DEL SUENO

Provider Business Mailing Address
First Line	:	PARQ SAN AGUSTIN
Second Line	:	1764 F PAZ GRANELA AV
City	:	SAN JUAN
State	:	PR
Zip	:	00923-3018
Country	:	US
Telephone Number	:	787-771-2500
Fax Number	:	787-771-2600

Provider Business Practice Location Address
First Line	:	PARQ SAN AGUSTIN
Second Line	:	1764 F PAZ GRANELA AV
City	:	SAN JUAN
State	:	PR
Zip	:	00923-3018
Country	:	US
Telephone Number	:	787-771-2500
Fax Number	:	787-771-2600

Authorized Official
Title or Position	:	GENERAL MANAGER
Name	:	ARTURO A JIMENEZ
Credential	:
Telephone Number	:	787-771-2500

Provider Enumeration Date	:	08/09/2016
Last Update Date	:	08/09/2016

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