Healthcare Provider Details

I. General information

NPI: 1477083459
Provider Name (Legal Business Name): WEST EYE SPECIALISTS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/13/2017
Last Update Date: 03/14/2022
Certification Date: 03/14/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

#2625 AVE HOSTOS STE 1
MAYAGUEZ PR
00682
US

IV. Provider business mailing address

2625 AVE HOSTOS STE 1
MAYAGUEZ PR
00682-6326
US

V. Phone/Fax

Practice location:
  • Phone: 787-476-0331
  • Fax: 787-476-0332
Mailing address:
  • Phone: 787-476-0331
  • Fax: 787-476-0332

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MS. NATALIA SOTO
Title or Position: ADMINISTRATOR
Credential: MBA
Phone: 787-476-0333