Healthcare Provider Details

I. General information

NPI: 1821100702
Provider Name (Legal Business Name): IRIS L. SANCHEZ OD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/31/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PUERTO RICO OPTICAL PLAZA CAPARRA LOCAL 16
GUAYNABO PR
00968
US

IV. Provider business mailing address

PUERTO RICO OPTICAL PLAZA CAPARRA LOCAL 16
GUAYNABO PR
00968
US

V. Phone/Fax

Practice location:
  • Phone: 787-783-1085
  • Fax: 787-781-2794
Mailing address:
  • Phone: 787-783-1085
  • Fax: 787-781-2794

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number137
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: