Healthcare Provider Details

I. General information

NPI: 1013970631
Provider Name (Legal Business Name): RAFAEL E TORO-LANDRON OD
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 04/07/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25A SAN ISIDROS ST
SABANA GRANDE PR
00637
US

IV. Provider business mailing address

25A SAN ISIDROS ST
SABANA GRANDE PR
00637
US

V. Phone/Fax

Practice location:
  • Phone: 787-804-0536
  • Fax: 787-804-0536
Mailing address:
  • Phone: 787-804-0536
  • Fax: 787-804-0536

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number458099
License Number StatePR
# 2
Primary TaxonomyN
Taxonomy Code152WC0802X
TaxonomyCorneal and Contact Management Optometrist
License Number458099
License Number StatePR
# 3
Primary TaxonomyY
Taxonomy Code152WL0500X
TaxonomyLow Vision Rehabilitation Optometrist
License Number458099
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: