Healthcare Provider Details

I. General information

NPI: 1942219415
Provider Name (Legal Business Name): CARIBE MEDICAL SUPPLY, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/05/2006
Last Update Date: 01/25/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1351 CALLE ANTONIO ARROYO ESQUINA PAZ GRANELA
SAN JUAN PR
00921-4223
US

IV. Provider business mailing address

URB CAMBRIDGE PARK A5 AVE. CHESNUT HILL
SAN JUAN PR
00921-0001
US

V. Phone/Fax

Practice location:
  • Phone: 787-783-0815
  • Fax: 787-783-0840
Mailing address:
  • Phone: 787-783-0815
  • Fax: 787-783-0840

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License NumberTC-AMB 330
License Number StatePR

VIII. Authorized Official

Name: MRS. BENJAMIN BISONO RODRIGUEZ
Title or Position: GERENTE GENERAL
Credential:
Phone: 787-783-0815