Provider Demographics
NPI:1194718643
Name:CAGUAS ORTHOPEDIC CENTER INC
Entity type:Organization
Organization Name:CAGUAS ORTHOPEDIC CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:GLADYS
Authorized Official - Middle Name:
Authorized Official - Last Name:ARCHILLA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-744-2325
Mailing Address - Street 1:VILLA DEL REY 4 FF4 CALLE 11
Mailing Address - Street 2:
Mailing Address - City:CAGUAS
Mailing Address - State:PR
Mailing Address - Zip Code:00725
Mailing Address - Country:US
Mailing Address - Phone:787-744-2325
Mailing Address - Fax:787-746-2474
Practice Address - Street 1:VILLA DEL REY 4 FF4 CALLE 11
Practice Address - Street 2:
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00725
Practice Address - Country:US
Practice Address - Phone:787-744-2325
Practice Address - Fax:787-746-2474
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-30
Last Update Date:2008-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR0503700001Medicare NSC