Provider Demographics
NPI:1356377451
Name:DIABETIC SOLUTIONS CORP
Entity type:Organization
Organization Name:DIABETIC SOLUTIONS CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JAIME
Authorized Official - Middle Name:XAVIER
Authorized Official - Last Name:PANTOJA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-884-3382
Mailing Address - Street 1:P O BOX 8885
Mailing Address - Street 2:
Mailing Address - City:VEGA BAJA
Mailing Address - State:PR
Mailing Address - Zip Code:00694
Mailing Address - Country:US
Mailing Address - Phone:787-884-3382
Mailing Address - Fax:787-854-2000
Practice Address - Street 1:URB FLAMBOYAN D9
Practice Address - Street 2:CALLE CORDOVA DAVILA
Practice Address - City:MANATI
Practice Address - State:PR
Practice Address - Zip Code:00674
Practice Address - Country:US
Practice Address - Phone:787-884-3382
Practice Address - Fax:787-854-2000
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR4952300001Medicare ID - Type UnspecifiedPROVIDER NUMBER