MEDICARE: PRO OXY RESPIRATORY SERVICES INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	335E00000X	Prosthetic/Orthotic Supplier
2	332BX2000X	Oxygen Equipment & Supplies (DME)	08P1347	PR

General Provider Information

NPI Number	:	1144345240
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PRO OXY RESPIRATORY SERVICES INC

Provider Business Mailing Address
First Line	:	951 AVE AMERICO MIRANDA
Second Line	:
City	:	SAN JUAN
State	:	PR
Zip	:	00921-2801
Country	:	US
Telephone Number	:	787-749-9744
Fax Number	:	787-754-1619

Provider Business Practice Location Address
First Line	:	AVE AMERICO MIRANDA
Second Line	:	#951
City	:	SAN JUAN
State	:	PR
Zip	:	00921-2801
Country	:	US
Telephone Number	:	787-749-9744
Fax Number	:	787-754-1619

Authorized Official
Title or Position	:	PRESIDENT
Name	:	JAIME SEPULVEDA
Credential	:
Telephone Number	:	787-749-9744

Provider Enumeration Date	:	03/20/2007
Last Update Date	:	03/30/2011

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Directions to “PRO OXY RESPIRATORY SERVICES INC ” Practice Location

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