Provider Demographics
NPI:1770586992
Name:ORTHO MEDIC INC
Entity type:Organization
Organization Name:ORTHO MEDIC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARGIE
Authorized Official - Middle Name:
Authorized Official - Last Name:BEZARES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-843-0648
Mailing Address - Street 1:1432 AVE MUNOZ RIVERA
Mailing Address - Street 2:
Mailing Address - City:PONCE
Mailing Address - State:PR
Mailing Address - Zip Code:00717-0202
Mailing Address - Country:US
Mailing Address - Phone:787-843-0648
Mailing Address - Fax:787-844-0085
Practice Address - Street 1:1432 AVE MUNOZ RIVERA
Practice Address - Street 2:
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00717-0202
Practice Address - Country:US
Practice Address - Phone:787-843-0648
Practice Address - Fax:787-844-0085
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-05-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR0824130001Medicare ID - Type UnspecifiedPROVIDER NO