Provider Demographics
NPI:1073754180
Name:MEDICAL POWER MOBILITY
Entity Type:Organization
Organization Name:MEDICAL POWER MOBILITY
Other - Org Name:MEDICAL POWER MOBILITY INC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MIGUEL
Authorized Official - Middle Name:ANGEL
Authorized Official - Last Name:DIAZ
Authorized Official - Suffix:SR
Authorized Official - Credentials:
Authorized Official - Phone:787-203-8912
Mailing Address - Street 1:URB FLAMBOYAN GDNS
Mailing Address - Street 2:Z33 CALLE 3A
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00959-5837
Mailing Address - Country:US
Mailing Address - Phone:787-203-8912
Mailing Address - Fax:787-740-5436
Practice Address - Street 1:Z33 CALLE 3A
Practice Address - Street 2:URB FLAMBOYAN GARDENS
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00959-5837
Practice Address - Country:US
Practice Address - Phone:787-203-8912
Practice Address - Fax:787-740-5436
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-19
Last Update Date:2014-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR6487460001Medicare PIN