Provider Demographics
NPI:1912043852
Name:EQUIPOS MEDICOS DE LARES, INC.
Entity Type:Organization
Organization Name:EQUIPOS MEDICOS DE LARES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:IVETTE
Authorized Official - Middle Name:L
Authorized Official - Last Name:ARIAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-897-6969
Mailing Address - Street 1:PO BOX 369
Mailing Address - Street 2:
Mailing Address - City:LARES
Mailing Address - State:PR
Mailing Address - Zip Code:00669-0369
Mailing Address - Country:US
Mailing Address - Phone:787-897-6969
Mailing Address - Fax:787-897-6797
Practice Address - Street 1:CARRETERA 129 KM 22.8
Practice Address - Street 2:BO. CALLEJONES
Practice Address - City:LARES
Practice Address - State:PR
Practice Address - Zip Code:00669
Practice Address - Country:US
Practice Address - Phone:787-897-6969
Practice Address - Fax:787-897-6797
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-29
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR1276900001Medicare ID - Type Unspecified