Healthcare Provider Details

I. General information

NPI: 1831192178
Provider Name (Legal Business Name): CARIBE MEDICAL SUPPLY, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/31/2005
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1351 CALLE ANTONIO ARROYO ESQ. PAZ GRAND A
SAN JUA PR
00921
US

IV. Provider business mailing address

A-5 CHESTNUT J HILL CAMBRIDGE PARK
SAN JUAN PR
00926
US

V. Phone/Fax

Practice location:
  • Phone: 787-783-0072
  • Fax: 787-783-0840
Mailing address:
  • Phone: 787-783-0085
  • Fax: 787-783-0840

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MRS. CARMEN L RODRIGUEZ
Title or Position: PRESIDENT
Credential:
Phone: 787-783-0085