MEDICARE: TIME ORTHOPEDIC CORP

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	332B00000X	Durable Medical Equipment & Medical Supplies

General Provider Information

NPI Number	:	1710988340
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TIME ORTHOPEDIC CORP

Provider Business Mailing Address
First Line	:	33 AVE SEVERIANO CUEVAS
Second Line	:	REPARTO LOPEZ
City	:	AGUADILLA
State	:	PR
Zip	:	00603-5713
Country	:	US
Telephone Number	:	787-882-0980
Fax Number	:	787-882-0985

Provider Business Practice Location Address
First Line	:	33 AVE SEVERIANO CUEVAS
Second Line	:
City	:	AGUADILLA
State	:	PR
Zip	:	00603-5713
Country	:	US
Telephone Number	:	787-882-0980
Fax Number	:	787-882-0985

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. CARLOS RODRIGUEZ
Credential	:
Telephone Number	:	787-882-0980

Provider Enumeration Date	:	08/04/2005
Last Update Date	:	08/22/2020

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