Provider Demographics
NPI:1326055922
Name:IMPLANTES Y SISTEMAS MEDICOS, INC
Entity Type:Organization
Organization Name:IMPLANTES Y SISTEMAS MEDICOS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATIVE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:IVELISE
Authorized Official - Middle Name:ROSELYN
Authorized Official - Last Name:VEGERANO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-273-8115
Mailing Address - Street 1:6 CALLE 1
Mailing Address - Street 2:METRO OFFICE PARK SUITE 80
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00968-1728
Mailing Address - Country:US
Mailing Address - Phone:787-273-8105
Mailing Address - Fax:
Practice Address - Street 1:6 CALLE 1
Practice Address - Street 2:METRO OFFICE PARK SUITE 80
Practice Address - City:GUAYNABO
Practice Address - State:PR
Practice Address - Zip Code:00968-1728
Practice Address - Country:US
Practice Address - Phone:787-273-8115
Practice Address - Fax:787-273-8105
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR4952400001Medicare ID - Type UnspecifiedDMERCS