| NPI | 1619014792 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SAMUEL CARRILLO President 787-448-2931 |
| Organization Subpart ? | No |
| Primary Taxonomy | 247200000X Technician, Other (Licence: PR 168488) |
| Additional Taxonomies | 335E00000X Prosthetic/Orthotic Supplier |
| 332B00000X Durable Medical Equipment & Medical Supplies | |
| Enumeration Date | 2007-01-30 |
| Last Update Date | 2013-08-14 |