Provider Demographics
NPI:1720005663
Name:MEDI PLUS PR INC
Entity Type:Organization
Organization Name:MEDI PLUS PR INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:EDITA
Authorized Official - Middle Name:
Authorized Official - Last Name:CUBILLA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-763-3049
Mailing Address - Street 1:443 CALLE CESAR GONZALEZ
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00918-2639
Mailing Address - Country:US
Mailing Address - Phone:787-763-3049
Mailing Address - Fax:787-763-5006
Practice Address - Street 1:443 CALLE CESAR GONZALEZ
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00918-2639
Practice Address - Country:US
Practice Address - Phone:787-763-3049
Practice Address - Fax:787-763-5006
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR07P2188332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR4106690001Medicare NSC