MEDICARE: KCI MEDICAL PUERTO RICO, INC.

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	5047	PR

General Provider Information

NPI Number	:	1952376279
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KCI MEDICAL PUERTO RICO, INC.

Provider Business Mailing Address
First Line	:	6103 FARINON DR
Second Line	:	ATTN HCC
City	:	SAN ANTONIO
State	:	TX
Zip	:	78249-3442
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	201 CARR 869
Second Line	:
City	:	CATANO
State	:	PR
Zip	:	00962-7015
Country	:	US
Telephone Number	:	787-275-3000
Fax Number	:

Authorized Official
Title or Position	:	VP, MEDICARE ENROLLMENT
Name	:	ROSA GOMEZ
Credential	:
Telephone Number	:	210-255-6503

Provider Enumeration Date	:	02/21/2006
Last Update Date	:	07/22/2025

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