Healthcare Provider Details

I. General information

NPI: 1427087246
Provider Name (Legal Business Name): DORADO MEDICAL SUPPLY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/02/2006
Last Update Date: 07/16/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

499 CALLE EXT SUR
DORADO PR
00646-5017
US

IV. Provider business mailing address

499 CALLE EXT SUR
DORADO PR
00646-5017
US

V. Phone/Fax

Practice location:
  • Phone: 787-796-6372
  • Fax: 787-796-6488
Mailing address:
  • Phone: 787-796-6372
  • Fax: 787-796-6488

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: MRS. EILEEN Y SIERRA
Title or Position: PRESIDENT
Credential:
Phone: 787-796-6372