Provider Demographics
NPI:1285374827
Name:ORTHOTECH ORTHOPEDIC GROUP LLC
Entity type:Organization
Organization Name:ORTHOTECH ORTHOPEDIC GROUP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:OSCAR
Authorized Official - Middle Name:J
Authorized Official - Last Name:FELICIANO RODRIGUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-312-0511
Mailing Address - Street 1:PO BOX 1539
Mailing Address - Street 2:
Mailing Address - City:MOCA
Mailing Address - State:PR
Mailing Address - Zip Code:00676-1539
Mailing Address - Country:US
Mailing Address - Phone:787-312-0511
Mailing Address - Fax:
Practice Address - Street 1:CARRETERA 365 KM 2.8 INTERIOR
Practice Address - Street 2:BO MOLINAS
Practice Address - City:SABANA GRANDE
Practice Address - State:PR
Practice Address - Zip Code:00637
Practice Address - Country:US
Practice Address - Phone:787-312-0511
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-31
Last Update Date:2022-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies