Healthcare Provider Details

I. General information

NPI: 1962427286
Provider Name (Legal Business Name): ELSA G. BARROSO-HERRANS O.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: ELSA G, BARROSO-HERRANS O.D.

II. Dates (important events)

Enumeration Date: 07/13/2006
Last Update Date: 02/19/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 CALLE CASIA VAMC
SAN JUAN PR
00921-3200
US

IV. Provider business mailing address

S28 CALLE R MENENDEZ PIDAL EL SENORIAL
SAN JUAN PR
00926-6921
US

V. Phone/Fax

Practice location:
  • Phone: 787-641-7582
  • Fax: 787-641-9533
Mailing address:
  • Phone: 787-641-7582
  • Fax: 787-641-9533

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code152WL0500X
TaxonomyLow Vision Rehabilitation Optometrist
License Number189
License Number StatePR
# 2
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number189
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: