Healthcare Provider Details

I. General information

NPI: 1770586992
Provider Name (Legal Business Name): ORTHO MEDIC INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/23/2005
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1432 AVE MUNOZ RIVERA
PONCE PR
00717-0202
US

IV. Provider business mailing address

1432 AVE MUNOZ RIVERA
PONCE PR
00717-0202
US

V. Phone/Fax

Practice location:
  • Phone: 787-843-0648
  • Fax: 787-844-0085
Mailing address:
  • Phone: 787-843-0648
  • Fax: 787-844-0085

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: MRS. MARGIE BEZARES
Title or Position: MANAGER
Credential:
Phone: 787-843-0648