Healthcare Provider Details

I. General information

NPI: 1326250275
Provider Name (Legal Business Name): BMP LASER COSMETIC CENTER CSP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/04/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

BAYAMON MEDICAL PLAZA SUITE 108
BAYAMON PR
00959
US

IV. Provider business mailing address

BAYAMON MEDICAL PLAZA SUITE 108
BAYAMON PR
00959
US

V. Phone/Fax

Practice location:
  • Phone: 787-740-2040
  • Fax: 787-288-8183
Mailing address:
  • Phone: 787-740-2040
  • Fax: 787-288-8183

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332H00000X
TaxonomyEyewear Supplier
License Number9255
License Number StatePR

VIII. Authorized Official

Name: DR. JOSE L FOSSAS BLANCO
Title or Position: MEDICAL DOCTOR
Credential: M.D
Phone: 787-740-2040