Healthcare Provider Details

I. General information

NPI: 1720089717
Provider Name (Legal Business Name): CONDADO SALES AND RENTAL, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/02/2005
Last Update Date: 01/13/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

186 CALLE JUAN P DUARTE FLORAL PARK
SAN JUAN PR
00917-3602
US

IV. Provider business mailing address

186 CALLE JUAN P DUARTE FLORAL PARK
SAN JUAN PR
00917-3602
US

V. Phone/Fax

Practice location:
  • Phone: 787-758-2325
  • Fax: 787-765-9876
Mailing address:
  • Phone: 787-758-2325
  • Fax: 787-765-9876

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332BP3500X
TaxonomyParenteral & Enteral Nutrition Supplies (DME)
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number
License Number State

VIII. Authorized Official

Name: MARIA DE LOURDES DE LEON
Title or Position: VICE PRESIDENT OF SERVICES
Credential: MS
Phone: 787-758-2325