Healthcare Provider Details

I. General information

NPI: 1801199443
Provider Name (Legal Business Name): HI-TECH PROSTHETICS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/20/2010
Last Update Date: 01/20/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

BO PUEBLO EDIF. 193 CARR 2 KM 86.4
HATILLO PR
00659
US

IV. Provider business mailing address

BO PUEBLO EDIF. 193 CARR 2 KM 86.4
HATILLO PR
00659
US

V. Phone/Fax

Practice location:
  • Phone: 787-262-4805
  • Fax: 787-882-9045
Mailing address:
  • Phone: 787-262-4805
  • Fax: 787-882-9045

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License NumberCP003218
License Number StateDE

VIII. Authorized Official

Name: MR. FRANK UCROS
Title or Position: PROSTHETIST
Credential: CP
Phone: 787-891-4805