Provider Demographics
NPI:1467589192
Name:DIABETICOS DEL CARIBE CORP
Entity Type:Organization
Organization Name:DIABETICOS DEL CARIBE CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:M
Authorized Official - Last Name:RIVERA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-752-8335
Mailing Address - Street 1:400 CALLE JUAN CALAF
Mailing Address - Street 2:SUITE 96
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00918-1314
Mailing Address - Country:US
Mailing Address - Phone:787-752-8335
Mailing Address - Fax:
Practice Address - Street 1:926 CALLE EIDER - ESQ. TORCAZA
Practice Address - Street 2:URB. COUNTRY CLUB
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00924
Practice Address - Country:US
Practice Address - Phone:787-752-8335
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-28
Last Update Date:2009-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR5235970001Medicare ID - Type UnspecifiedPALMETTO GBA