Healthcare Provider Details

I. General information

NPI: 1275528820
Provider Name (Legal Business Name): OR PRO MEDICAL INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/20/2005
Last Update Date: 11/26/2024
Certification Date: 11/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1630 AVE J T PINERO
SAN JUAN PR
00921-1423
US

IV. Provider business mailing address

1630 AVE J T PINERO
SAN JUAN PR
00921-1423
US

V. Phone/Fax

Practice location:
  • Phone: 787-783-8558
  • Fax: 787-783-5653
Mailing address:
  • Phone: 787-783-8558
  • Fax: 787-783-5653

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License Number02175
License Number StateDE

VIII. Authorized Official

Name: MR. BENIGNO GARCIA
Title or Position: PRESIDENT
Credential: CPO
Phone: 787-783-8558