Healthcare Provider Details

I. General information

NPI: 1316452733
Provider Name (Legal Business Name): BIOMEDTECH OF PR
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/07/2017
Last Update Date: 12/07/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CARR 788 KM 2.1
SAN LORENZO PR
00725
US

IV. Provider business mailing address

20 AVE LUIS MUNOZ MARIN PMB 280
CAGUAS PR
00725
US

V. Phone/Fax

Practice location:
  • Phone: 787-586-3700
  • Fax:
Mailing address:
  • Phone: 787-586-3700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171W00000X
TaxonomyContractor
License Number
License Number StatePR
# 2
Primary TaxonomyN
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number StatePR

VIII. Authorized Official

Name: JOEL VEGA
Title or Position: OWNER
Credential:
Phone: 787-586-3700