Provider Demographics
NPI:1699713800
Name:TECH MEDICAL GROUP, INC.
Entity type:Organization
Organization Name:TECH MEDICAL GROUP, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CARLOS
Authorized Official - Middle Name:R
Authorized Official - Last Name:MERCADO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-759-0460
Mailing Address - Street 1:PO BOX 195137
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00919-5137
Mailing Address - Country:US
Mailing Address - Phone:787-759-0460
Mailing Address - Fax:787-751-6949
Practice Address - Street 1:219 CALLE LAS MARIAS
Practice Address - Street 2:HYDE PARK
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00927-4224
Practice Address - Country:US
Practice Address - Phone:787-759-0460
Practice Address - Fax:787-751-6949
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR87174335E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier