Healthcare Provider Details

I. General information

NPI: 1407996283
Provider Name (Legal Business Name): NITZA MAYRA CHAAR GARCIA DOCTORATE OD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/08/2007
Last Update Date: 11/21/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CALLE 2 KM 63.8 CANDELARIA SABANA HOYOS
ARECIBO PR
00612
US

IV. Provider business mailing address

PO BOX 143154
ARECIBO PR
00614-3154
US

V. Phone/Fax

Practice location:
  • Phone: 787-878-2460
  • Fax: 787-878-2460
Mailing address:
  • Phone: 787-878-2460
  • Fax: 787-878-2460

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number#425
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: