Provider Demographics
NPI:1336145143
Name:MASTER ORTHOPEDIC INC
Entity Type:Organization
Organization Name:MASTER ORTHOPEDIC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:
Authorized Official - Last Name:FOJO
Authorized Official - Suffix:
Authorized Official - Credentials:CPO
Authorized Official - Phone:787-982-3393
Mailing Address - Street 1:1811 CALLE LOISA
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00911
Mailing Address - Country:US
Mailing Address - Phone:787-982-3393
Mailing Address - Fax:787-982-3353
Practice Address - Street 1:CALLE LOISA SUITE 1811
Practice Address - Street 2:
Practice Address - City:SANTURCE
Practice Address - State:PR
Practice Address - Zip Code:00911
Practice Address - Country:US
Practice Address - Phone:787-982-3393
Practice Address - Fax:787-982-3353
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR4313890001Medicare ID - Type UnspecifiedMEDICARE ID