Provider Demographics
NPI:1023844719
Name:EDWARDS LIFESCIENCES PUERTO RICO CORPORATION
Entity type:Organization
Organization Name:EDWARDS LIFESCIENCES PUERTO RICO CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:
Authorized Official - Last Name:ALEJANDRO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-607-8317
Mailing Address - Street 1:350 AVE CARLOS CHARDON STE 119
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00918-2139
Mailing Address - Country:US
Mailing Address - Phone:787-675-1288
Mailing Address - Fax:
Practice Address - Street 1:350 AVE CARLOS CHARDON STE 119
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00918-2139
Practice Address - Country:US
Practice Address - Phone:787-675-1288
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-10
Last Update Date:2024-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies