MEDICARE: ORTHOBONE SURGICAL, 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	332B00000X	Durable Medical Equipment & Medical Supplies

General Provider Information

NPI Number	:	1861728552
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ORTHOBONE SURGICAL, INC.

Provider Business Mailing Address
First Line	:	1700 CALLE SANTA AGUEDA
Second Line	:	URB SAN GERARDO
City	:	SAN JUAN
State	:	PR
Zip	:	00926
Country	:	US
Telephone Number	:	787-754-1059
Fax Number	:

Provider Business Practice Location Address
First Line	:	1700 CALLE SANTA AGUEDA
Second Line	:	URB SAN GERARDO
City	:	SAN JUAN
State	:	PR
Zip	:	00926
Country	:	US
Telephone Number	:	787-754-1059
Fax Number	:

Authorized Official
Title or Position	:	MEDICAL DIRECTOR
Name	:	DR. MICHAEL F SOLER
Credential	:	MD
Telephone Number	:	787-754-1059

Provider Enumeration Date	:	10/30/2009
Last Update Date	:	10/30/2009

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