Healthcare Provider Details

I. General information

NPI: 1033558200
Provider Name (Legal Business Name): CARIBBEAN ORTHOPEDICS OF PUERTO RICO LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/20/2013
Last Update Date: 06/20/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

AVE. LUIS VIGOREAUX X3 VILLA CAPARRA
GUAYNABO PR
00966-2434
US

IV. Provider business mailing address

PO BOX 367667
SAN JUAN PR
00936-7667
US

V. Phone/Fax

Practice location:
  • Phone: 787-783-9400
  • Fax: 787-781-7089
Mailing address:
  • Phone: 787-783-9400
  • Fax: 787-781-7089

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: MR. JORGE DE JESUS
Title or Position: GENERAL MANAGER
Credential:
Phone: 787-297-5584