Healthcare Provider Details

I. General information

NPI: 1710939285
Provider Name (Legal Business Name): MEDIQUIP SERVICES CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/16/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

AB5 CALLE NEBRASKA URB CAGUAS NORTE
CAGUAS PR
00725-2240
US

IV. Provider business mailing address

AB5 CALLE NEBRASKA URB CAGUAS NORTE
CAGUAS PR
00725-2240
US

V. Phone/Fax

Practice location:
  • Phone: 787-704-0421
  • Fax: 787-746-8551
Mailing address:
  • Phone: 787-704-0421
  • Fax: 787-746-8551

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0400X
TaxonomyRehabilitation Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: HUMBERTO JOSE RODRIGUEZ
Title or Position: PRESIDENT
Credential:
Phone: 787-704-0421