Provider Demographics
NPI:1609802834
Name:FIRST CHOICE PROSTHETIC & OTRHOPEDIC SERVICE INC
Entity Type:Organization
Organization Name:FIRST CHOICE PROSTHETIC & OTRHOPEDIC SERVICE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:MARIO
Authorized Official - Middle Name:
Authorized Official - Last Name:GARCIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-437-1601
Mailing Address - Street 1:PO BOX 800942
Mailing Address - Street 2:
Mailing Address - City:COTO LAUREL
Mailing Address - State:PR
Mailing Address - Zip Code:00780-0942
Mailing Address - Country:US
Mailing Address - Phone:787-284-6184
Mailing Address - Fax:787-812-1868
Practice Address - Street 1:SAINT LUKE'S MEM HOSPITAL II LOBBY C SUITE 3
Practice Address - Street 2:14 ROAD
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00731
Practice Address - Country:US
Practice Address - Phone:787-284-6184
Practice Address - Fax:787-812-1868
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-22
Last Update Date:2023-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR4284520001Medicare NSC