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General NPI Number Information
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NPI Number | 1134593577
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Entity Type | Organization
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Legal Business Name | JOSE RAUL MONTES EYES & FACIAL REJUVENATION, LLC
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Dates
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Enumeration Date | 11/23/2015
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Last Update Date | 11/23/2015
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Provider Practice Location Address
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Address Line | 735 AVE. PONCE DE LEON SUITE 813 TORRE MEDICA AUXILIO MUTUO
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City | SAN JUAN
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State | PR
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Zip | 00917
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Country | US
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Telephone | 787-777-0003
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Fax | 787-777-0004
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Provider Business Mailing Address
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Address Line | 735 AVE. PONCE DE LEON SUITE 813 TORRE MEDICA AUXILIO MUTUO
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City | SAN JUAN
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State | PR
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Zip | 00917
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Country | US
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Telephone | 787-777-0003
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Fax | 787-777-0004
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Authorized Official
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Title or Position | PRESIDENTE-(OWNER)
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Name | MR. JOSE RAUL MONTES PAGAN
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Credential | M.D.
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Telephone | 787-777-0003
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number |
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License Number State | PR
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