Organization
MARN PROSTHETIC LABORATORY MEDICAL CENTER INC
Active
Organization
MARN PROSTHETIC LABORATORY MEDICAL CENTER INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MIGUEL A RIVERA (PRESIDENT)
(787) 769-6849
Entity
Organization
Contact information
Practice address
AVE ITURREGUI OE 12, 4TA EXT COUNTRY CLUB, CAROLINA, PR 00982
(787) 769-6849
(787) 769-6849
Mailing address
PO BOX 29431, SAN JUAN, PR 00929-0431
(787) 769-6849
(787) 769-6849
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
CF001018
PR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
50393
PREFERRED MEDICARE CHOICE
PR
01
—
55238
TRIPLE S
PR
Enumeration date
06/30/2006
Last updated
01/22/2010
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