Provider Demographics
NPI:1710269287
Name:ORTHOCARIBBEAN P.C.
Entity Type:Organization
Organization Name:ORTHOCARIBBEAN P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:VAN ALLEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:340-692-5000
Mailing Address - Street 1:PO BOX 1095
Mailing Address - Street 2:
Mailing Address - City:CHRISTIANSTED
Mailing Address - State:VI
Mailing Address - Zip Code:00821-1095
Mailing Address - Country:US
Mailing Address - Phone:340-692-5000
Mailing Address - Fax:340-692-5002
Practice Address - Street 1:4201 ESTATE RUBY
Practice Address - Street 2:SUITE 1
Practice Address - City:CHRISTIANSTED
Practice Address - State:VI
Practice Address - Zip Code:00820
Practice Address - Country:US
Practice Address - Phone:340-692-5000
Practice Address - Fax:340-692-5002
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-12
Last Update Date:2012-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VI653207X00000X, 335E00000X
VI1499207XS0117X, 335E00000X
207XX0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty
No207XS0117XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the SpineGroup - Multi-Specialty
No207XX0801XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic TraumaGroup - Multi-Specialty
No335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
VI5914195Medicaid
VI0397730004Medicare NSC
VI5914195Medicaid