Provider Demographics
NPI:1578861274
Name:EQUIPOS MEDICOS DE CANOVANAS
Entity Type:Organization
Organization Name:EQUIPOS MEDICOS DE CANOVANAS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ILEANA
Authorized Official - Middle Name:
Authorized Official - Last Name:DURAN
Authorized Official - Suffix:
Authorized Official - Credentials:MT
Authorized Official - Phone:787-876-3697
Mailing Address - Street 1:PO BOX 10000
Mailing Address - Street 2:PMB 157
Mailing Address - City:CANOVANAS
Mailing Address - State:PR
Mailing Address - Zip Code:00729
Mailing Address - Country:US
Mailing Address - Phone:787-876-3697
Mailing Address - Fax:
Practice Address - Street 1:68 CALLE BETANCES
Practice Address - Street 2:
Practice Address - City:CANOVANAS
Practice Address - State:PR
Practice Address - Zip Code:00729-3243
Practice Address - Country:US
Practice Address - Phone:787-876-3697
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-03
Last Update Date:2012-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies