MEDICARE: CONDADO SALES AND RENTAL, 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	332BP3500X	Parenteral & Enteral Nutrition Supplies (DME)
2	332BX2000X	Oxygen Equipment & Supplies (DME)

General Provider Information

NPI Number	:	1720089717
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CONDADO SALES AND RENTAL, INC

Provider Business Mailing Address
First Line	:	186 CALLE JUAN P DUARTE
Second Line	:	FLORAL PARK
City	:	SAN JUAN
State	:	PR
Zip	:	00917-3602
Country	:	US
Telephone Number	:	787-758-2325
Fax Number	:	787-765-9876

Provider Business Practice Location Address
First Line	:	186 CALLE JUAN P DUARTE
Second Line	:	FLORAL PARK
City	:	SAN JUAN
State	:	PR
Zip	:	00917-3602
Country	:	US
Telephone Number	:	787-758-2325
Fax Number	:	787-765-9876

Authorized Official
Title or Position	:	VICE PRESIDENT OF SERVICES
Name	:	MARIA DE LOURDES DE LEON
Credential	:	MS
Telephone Number	:	787-758-2325

Provider Enumeration Date	:	08/02/2005
Last Update Date	:	01/13/2010

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