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General NPI Number Information
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NPI Number | 1013230549
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Entity Type | Organization
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Legal Business Name | MMT MEDICAL SUPPLY CORP.
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Dates
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Enumeration Date | 03/11/2010
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Last Update Date | 10/03/2011
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Provider Practice Location Address
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Address Line | URBANIZACION LAS LOMAS #772D AVENIDA SAN PATRICIO
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City | SAN JUAN
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State | PR
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Zip | 00921-1303
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Country | US
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Telephone | 787-783-6807
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Fax |
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Provider Business Mailing Address
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Address Line | URBANIZACION LAS LOMAS #772D AVENIDA SAN PATRICIO
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City | SAN JUAN
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State | PR
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Zip | 00921-1303
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Country | US
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Telephone | 787-783-6807
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Fax | 787-783-6807
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. CARLOS MIZRAHI
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Credential |
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Telephone | 787-783-6807
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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