Provider Demographics
NPI:1508649963
Name:MOST VALUABLE ORTHOPEDICS PROSTHETIC, LLC
Entity Type:Organization
Organization Name:MOST VALUABLE ORTHOPEDICS PROSTHETIC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:IVAN
Authorized Official - Middle Name:JADIEL
Authorized Official - Last Name:SEPULVEDA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:939-610-3575
Mailing Address - Street 1:PMB 124 UU-1 CALLE 39 SANTA JUANITA
Mailing Address - Street 2:
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00956
Mailing Address - Country:US
Mailing Address - Phone:787-415-4216
Mailing Address - Fax:
Practice Address - Street 1:204 CALLE GUAYAMA
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00917-4203
Practice Address - Country:US
Practice Address - Phone:939-610-7535
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-17
Last Update Date:2023-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
No335E00000XSuppliersProsthetic/Orthotic Supplier