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General NPI Number Information
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NPI Number | 1427109586
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Entity Type | Organization
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Legal Business Name | LABORATORIOS PROSTETICOS DE PUERTO RICO
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Dates
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Enumeration Date | 01/16/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 167 CALLE ANDRES ARUS RIVERA W
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City | GURABO
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State | PR
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Zip | 00778-2335
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Country | US
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Telephone | 787-737-6931
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Fax |
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Provider Business Mailing Address
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Address Line | 167 CALLE ANDRES ARUS RIVERA W
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City | GURABO
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State | PR
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Zip | 00778-2335
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Country | US
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Telephone | 787-737-6931
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. PEDRO LUIS LLANES
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Credential |
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Telephone | 305-250-9900
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 335E00000X
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Taxonomy Name | Prosthetic/Orthotic Supplier
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License Number | POR100
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License Number State | FL
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