Healthcare Provider Details

I. General information

NPI: 1356351035
Provider Name (Legal Business Name): CAGUAS SP INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

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

III. Provider practice location address

CALLE LAS PIEDRAS VV 1, ESQ. DEGETAU AVE BONN. HEIGTHS
CAGUAS PR
00725-7139
US

IV. Provider business mailing address

PO BOX 7139
CAGUAS PR
00726-7139
US

V. Phone/Fax

Practice location:
  • Phone: 787-746-3814
  • Fax: 787-744-2605
Mailing address:
  • Phone: 787-746-3814
  • Fax: 787-744-2605

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number07F1281
License Number StatePR
# 2
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number10533800001
License Number StatePR

VIII. Authorized Official

Name: DR. VICTOR JOSE DE JESUS I
Title or Position: PRESIDENT
Credential: MD
Phone: 787-746-3814