Provider Demographics
NPI:1326540584
Name:MEDITECH LLC
Entity Type:Organization
Organization Name:MEDITECH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTORIZED DELEGATE
Authorized Official - Prefix:MS
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:
Authorized Official - Last Name:MARTINEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-688-9944
Mailing Address - Street 1:URB PRADO ALTO
Mailing Address - Street 2:CALLE 1 P5
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00966
Mailing Address - Country:US
Mailing Address - Phone:787-688-9944
Mailing Address - Fax:787-998-0735
Practice Address - Street 1:1353 AVE LUIS VIGOREAUX
Practice Address - Street 2:PMB 306
Practice Address - City:GUAYNABO
Practice Address - State:PR
Practice Address - Zip Code:00966
Practice Address - Country:US
Practice Address - Phone:787-688-9944
Practice Address - Fax:787-998-0735
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-05
Last Update Date:2018-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Multi-Specialty