Provider Demographics
NPI:1033558200
Name:CARIBBEAN ORTHOPEDICS OF PUERTO RICO LLC
Entity Type:Organization
Organization Name:CARIBBEAN ORTHOPEDICS OF PUERTO RICO LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:JORGE
Authorized Official - Middle Name:
Authorized Official - Last Name:DE JESUS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-297-5584
Mailing Address - Street 1:PO BOX 367667
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00936-7667
Mailing Address - Country:US
Mailing Address - Phone:787-783-9400
Mailing Address - Fax:787-781-7089
Practice Address - Street 1:AVE. LUIS VIGOREAUX
Practice Address - Street 2:X3 VILLA CAPARRA
Practice Address - City:GUAYNABO
Practice Address - State:PR
Practice Address - Zip Code:00966-2434
Practice Address - Country:US
Practice Address - Phone:787-783-9400
Practice Address - Fax:787-781-7089
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-20
Last Update Date:2013-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No335E00000XSuppliersProsthetic/Orthotic Supplier