Organization
VIDACARE PR LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SANDRO PEREZ (PRESIDENTE)
(939) 245-7191
Entity
Organization
Contact information
Practice address
URB LOS TAMARINDOS 1, D14 CALLE 8, SAN LORENZO, PR 00754
(939) 245-7191
Mailing address
URB LOS TAMARINDOS 1, D14 CALLE 8, SAN LORENZO, PR 00754
Taxonomy
Speciality
Code
Description
License number
State
332900000X
Non-Pharmacy Dispensing Site
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
332BD1200X
Dialysis Equipment & Supplies (DME)
—
—
332BN1400X
Nursing Facility Supplies (DME)
—
—
332BX2000X
Oxygen Equipment & Supplies (DME)
—
—
Other
Enumeration date
07/09/2025
Last updated
07/09/2025
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