Healthcare Provider Details

I. General information

NPI: 1457407546
Provider Name (Legal Business Name): JUAN J FRIAS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/25/2007
Last Update Date: 01/23/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

SANTOS AMADEO ST 3
SALINAS PR
00751
US

IV. Provider business mailing address

PO BOX 1154
SALINAS PR
00751-1154
US

V. Phone/Fax

Practice location:
  • Phone: 787-824-1066
  • Fax: 787-824-1311
Mailing address:
  • Phone: 787-824-1066
  • Fax: 787-824-1311

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
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: JUAN J FRIAS
Title or Position: OWNER
Credential:
Phone: 787-824-1066