Provider Demographics
NPI:1427230952
Name:EMILIO O VINCENTY-ASAD
Entity Type:Organization
Organization Name:EMILIO O VINCENTY-ASAD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:EMILIO
Authorized Official - Middle Name:
Authorized Official - Last Name:VINCENTY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-265-5600
Mailing Address - Street 1:PO BOX 1903
Mailing Address - Street 2:
Mailing Address - City:MAYAGUEZ
Mailing Address - State:PR
Mailing Address - Zip Code:00681-1903
Mailing Address - Country:US
Mailing Address - Phone:787-265-5600
Mailing Address - Fax:787-805-1044
Practice Address - Street 1:134 CALLE DR VADI
Practice Address - Street 2:BO CRISTY
Practice Address - City:MAYAGUEZ
Practice Address - State:PR
Practice Address - Zip Code:00680-3732
Practice Address - Country:US
Practice Address - Phone:787-265-5600
Practice Address - Fax:787-805-1044
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-27
Last Update Date:2007-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR1034330001Medicare NSC