Healthcare Provider Details

I. General information

NPI: 1083958763
Provider Name (Legal Business Name): ORTHO CARIBE INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/19/2012
Last Update Date: 11/19/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CALLE GOYCO #56 PUEBLO
CAGUAS PR
00725
US

IV. Provider business mailing address

PMB 95 PO BOX 70344
SAN JUAN PR
00936
US

V. Phone/Fax

Practice location:
  • Phone: 939-246-3179
  • Fax:
Mailing address:
  • Phone: 939-246-3179
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License Number
License Number State

VIII. Authorized Official

Name: ADRIAN FERNANDO LUGO QUINTERO
Title or Position: PRESIDENT & CEO
Credential:
Phone: 939-246-3179