Provider Demographics
NPI:1770866741
Name:ORTHOCARIBBEAN PC
Entity Type:Organization
Organization Name:ORTHOCARIBBEAN PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:BRENDA
Authorized Official - Middle Name:
Authorized Official - Last Name:PEDERSEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:340-778-6110
Mailing Address - Street 1:PO BOX 7840
Mailing Address - Street 2:
Mailing Address - City:CHRISTIANSTED
Mailing Address - State:VI
Mailing Address - Zip Code:00823-7840
Mailing Address - Country:US
Mailing Address - Phone:340-778-6110
Mailing Address - Fax:340-778-2919
Practice Address - Street 1:SUNNY ISLE PROFESSIONAL BLDG
Practice Address - Street 2:SUITE 3F
Practice Address - City:CHRISTIANSTED
Practice Address - State:VI
Practice Address - Zip Code:00820-4423
Practice Address - Country:US
Practice Address - Phone:340-778-6110
Practice Address - Fax:340-778-2919
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-26
Last Update Date:2011-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VI1499332B00000X, 335E00000X
VI653335E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies