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General NPI Number Information
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NPI Number | 1639489297
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Entity Type | Organization
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Legal Business Name | DIABETIC SOLUTIONS MEDICAL EQUIPMENT & PROSTHETIC CORP
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Dates
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Enumeration Date | 10/18/2010
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Last Update Date | 10/18/2010
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Provider Practice Location Address
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Address Line | STREET 3 D12 CORDOVA DAVILA URB FLAMBOYAN
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City | MANATI
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State | PR
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Zip | 00674-0000
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Country | US
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Telephone | 787-854-6700
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Fax | 787-854-2000
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Provider Business Mailing Address
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Address Line | PO BOX 8885 SABANA BRANCH
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City | VEGA BAJA
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State | PR
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Zip | 00694-8885
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Country | US
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Telephone | 787-854-6700
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Fax | 787-854-2000
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. JAIME XAVIER PANTOJA
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Credential |
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Telephone | 787-884-3382
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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 |
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License Number State |
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