Provider Demographics
NPI:1639489297
Name:DIABETIC SOLUTIONS MEDICAL EQUIPMENT & PROSTHETIC CORP
Entity Type:Organization
Organization Name:DIABETIC SOLUTIONS MEDICAL EQUIPMENT & PROSTHETIC CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JAIME
Authorized Official - Middle Name:XAVIER
Authorized Official - Last Name:PANTOJA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-884-3382
Mailing Address - Street 1:PO BOX 8885 SABANA BRANCH
Mailing Address - Street 2:
Mailing Address - City:VEGA BAJA
Mailing Address - State:PR
Mailing Address - Zip Code:00694-8885
Mailing Address - Country:US
Mailing Address - Phone:787-854-6700
Mailing Address - Fax:787-854-2000
Practice Address - Street 1:STREET 3 D12 CORDOVA DAVILA
Practice Address - Street 2:URB FLAMBOYAN
Practice Address - City:MANATI
Practice Address - State:PR
Practice Address - Zip Code:00674-0000
Practice Address - Country:US
Practice Address - Phone:787-854-6700
Practice Address - Fax:787-854-2000
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-18
Last Update Date:2010-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier