Healthcare Provider Details

I. General information

NPI: 1598997009
Provider Name (Legal Business Name): AGUADILLA EYE MD PSC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/17/2009
Last Update Date: 05/19/2020
Certification Date: 05/19/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13 CALLE MERCEDES MORENO
AGUADILLA PR
00603-5152
US

IV. Provider business mailing address

PO BOX 968
AGUADILLA PR
00605-0968
US

V. Phone/Fax

Practice location:
  • Phone: 787-882-6370
  • Fax: 787-882-6373
Mailing address:
  • Phone: 787-882-6370
  • Fax: 787-882-6373

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207WX0107X
TaxonomyRetina Specialist (Ophthalmology) Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207WX0200X
TaxonomyOphthalmic Plastic and Reconstructive Surgery Physician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. CRISTINA FERRARI LUGO
Title or Position: OWNER
Credential: M.D.
Phone: 787-882-6370