Healthcare Provider Details

I. General information

NPI: 1194718643
Provider Name (Legal Business Name): CAGUAS ORTHOPEDIC CENTER INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/30/2005
Last Update Date: 08/23/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

VILLA DEL REY 4 FF4 CALLE 11
CAGUAS PR
00725
US

IV. Provider business mailing address

VILLA DEL REY 4 FF4 CALLE 11
CAGUAS PR
00725
US

V. Phone/Fax

Practice location:
  • Phone: 787-744-2325
  • Fax: 787-746-2474
Mailing address:
  • Phone: 787-744-2325
  • Fax: 787-746-2474

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License Number
License Number State

VIII. Authorized Official

Name: MRS. GLADYS ARCHILLA
Title or Position: PRESIDENT
Credential:
Phone: 787-744-2325