Healthcare Provider Details
I. General information
NPI: 1225267420
Provider Name (Legal Business Name): CAIEPA, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/08/2009
Last Update Date: 08/12/2009
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
359 CALLE SAN CLAUDIO SUITE 305-B
SAN JUAN PR
00926-9907
US
IV. Provider business mailing address
359 CALLE SAN CLAUDIO SUITE 305-B
SAN JUAN PR
00926-9907
US
V. Phone/Fax
- Phone: 787-460-1587
- Fax:
- Phone: 787-460-1587
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 152WL0500X |
| Taxonomy | Low Vision Rehabilitation Optometrist |
| License Number | 110 |
| License Number State | PR |
VIII. Authorized Official
Name: DR.
LUIS
PADILLA ZAPATA
Title or Position: CORPORATE PRESIDENT
Credential: O.D.
Phone: 787-460-1587