Healthcare Provider Details
I. General information
NPI: 1093030355
Provider Name (Legal Business Name): OJOS PUERTO RICO SERVICIOS CLINICOS PSC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/30/2010
Last Update Date: 07/01/2025
Certification Date: 06/12/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
METROPAVIA CLINIC ZONA INDUSTRIAL VICTOR ROJAS 2
ARECIBO PR
00613
US
IV. Provider business mailing address
PO BOX 589
DORADO PR
00646-0589
US
V. Phone/Fax
- Phone: 787-820-8989
- Fax: 787-820-6715
- Phone: 787-820-8989
- Fax: 787-820-6715
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207W00000X |
| Taxonomy | Ophthalmology Physician |
| License Number | 15856 |
| License Number State | PR |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208D00000X |
| Taxonomy | General Practice Physician |
| License Number | 15856 |
| License Number State | PR |
VIII. Authorized Official
Name:
OSCAR
ALEJANDRO
HERNANDEZ
Title or Position: CEO
Credential: MD
Phone: 787-820-8989