Organization
ELIEL ORTHO MEDICAL CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CARMEN NOEMI DIANA (PRESIDENT)
(787) 410-0063
Entity
Organization
Contact information
Practice address
JESUS T PINERO AVE 256B, UNIVERSITY GARDENS, SAN JUAN, PR 00927
(787) 754-2926
(787) 754-4259
Mailing address
JESUS T PINERO AVE 256B, UNIVERSITY GARDENS, SAN JUAN, PR 00927
(787) 754-2926
(787) 754-4259
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
55464
TRIPLE C
PR
01
—
61261
TRIPLES HEALTH PLAN
PR
01
—
8200095
HUMANA
PR
Enumeration date
11/30/2005
Last updated
08/22/2020
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