Provider Demographics
NPI:1558364943
Name:ACE MOVIMIENTO INC ORTHOTIC PROSTHETIC LABORATORIES
Entity Type:Organization
Organization Name:ACE MOVIMIENTO INC ORTHOTIC PROSTHETIC LABORATORIES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:E
Authorized Official - Last Name:LINK
Authorized Official - Suffix:
Authorized Official - Credentials:BOCO, CO
Authorized Official - Phone:787-288-0255
Mailing Address - Street 1:IA3 AVE LOMAS VERDES
Mailing Address - Street 2:ROYAL PALM
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00956-3133
Mailing Address - Country:US
Mailing Address - Phone:787-288-0255
Mailing Address - Fax:787-288-0800
Practice Address - Street 1:IA3 AVE LOMAS VERDES
Practice Address - Street 2:
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00956-3133
Practice Address - Country:US
Practice Address - Phone:787-288-0255
Practice Address - Fax:787-288-0800
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-05-31
Last Update Date:2011-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR0903660001Medicare ID - Type UnspecifiedMEDICARE PRIMARY LOCATION