Healthcare Provider Details

I. General information

NPI: 1942351812
Provider Name (Legal Business Name): CARIBBEAN PULMONARY CARE, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/16/2007
Last Update Date: 04/30/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

598 CALLE ALDEBARAN STE 101 URB. ALTAMIRA
SAN JUAN PR
00921-9999
US

IV. Provider business mailing address

PO BOX 7891 PMB 369
GUAYNABO PR
00970-7891
US

V. Phone/Fax

Practice location:
  • Phone: 787-304-0446
  • Fax: 787-781-3901
Mailing address:
  • Phone: 787-304-0446
  • Fax: 787-781-3901

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 Code332BP3500X
TaxonomyParenteral & Enteral Nutrition Supplies (DME)
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number08-P-1385
License Number StatePR

VIII. Authorized Official

Name: MR. ROBERTO HERNANDEZ
Title or Position: PRESIDENT
Credential: MHSA
Phone: 787-304-0446