Provider Demographics
NPI:1730738675
Name:CARIBBEAN SHOULDER AND ELBOW INSTITUTE
Entity type:Organization
Organization Name:CARIBBEAN SHOULDER AND ELBOW INSTITUTE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:ALBERTO
Authorized Official - Last Name:RODRIGUEZ DIAZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-955-3331
Mailing Address - Street 1:710 CALLE UN APT 202
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00907-4238
Mailing Address - Country:US
Mailing Address - Phone:787-955-3331
Mailing Address - Fax:
Practice Address - Street 1:CALLE 1 MARGINAL CARR#2
Practice Address - Street 2:LOCAL ESQUINA 3-B
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00959
Practice Address - Country:US
Practice Address - Phone:787-622-5420
Practice Address - Fax:787-625-2490
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-04
Last Update Date:2020-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies