Healthcare Provider Details

I. General information

NPI: 1699713800
Provider Name (Legal Business Name): TECH MEDICAL GROUP, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/02/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

219 CALLE LAS MARIAS HYDE PARK
SAN JUAN PR
00927-4224
US

IV. Provider business mailing address

PO BOX 195137
SAN JUAN PR
00919-5137
US

V. Phone/Fax

Practice location:
  • Phone: 787-759-0460
  • Fax: 787-751-6949
Mailing address:
  • Phone: 787-759-0460
  • Fax: 787-751-6949

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License Number87174
License Number StatePR

VIII. Authorized Official

Name: CARLOS R MERCADO
Title or Position: PRESIDENT
Credential:
Phone: 787-759-0460