Provider Demographics
NPI:1336425347
Name:ORTHOZ CORPORATION
Entity Type:Organization
Organization Name:ORTHOZ CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JASON
Authorized Official - Middle Name:DOUGLAS
Authorized Official - Last Name:NASH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-319-6045
Mailing Address - Street 1:PMB 347 609 AVE. TITO CASTRO
Mailing Address - Street 2:SUITE 102
Mailing Address - City:PONCE
Mailing Address - State:PUERTO RICO
Mailing Address - Zip Code:00716
Mailing Address - Country:UM
Mailing Address - Phone:787-319-6045
Mailing Address - Fax:800-933-1072
Practice Address - Street 1:90 CALLE COMERCIO
Practice Address - Street 2:
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00730-5002
Practice Address - Country:US
Practice Address - Phone:787-319-6045
Practice Address - Fax:800-933-1072
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-24
Last Update Date:2011-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier