Healthcare Provider Details

I. General information

NPI: 1548279490
Provider Name (Legal Business Name): ATLANTIC MED-CARE INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/07/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

FOREST HILLS CALLE 21 A19
BAYAMON PR
00959-5552
US

IV. Provider business mailing address

PO BOX 51346
TOA BAJA PR
00950-1346
US

V. Phone/Fax

Practice location:
  • Phone: 787-798-3507
  • Fax: 787-798-3507
Mailing address:
  • Phone: 787-798-3507
  • Fax: 787-798-3507

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number4667460001
License Number StatePR
# 2
Primary TaxonomyN
Taxonomy Code332BP3500X
TaxonomyParenteral & Enteral Nutrition Supplies (DME)
License Number56.05.06
License Number StatePR
# 3
Primary TaxonomyN
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number05-P-2113
License Number StatePR
# 4
Primary TaxonomyN
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License NumberABC CERTIFIED FITTER
License Number StatePR

VIII. Authorized Official

Name: EDUARDO JIMENEZ
Title or Position: PRESIDENT
Credential:
Phone: 787-798-3507