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General NPI Number Information
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NPI Number | 1194000638
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Entity Type | Individual
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Provider Name | IRIS THAMARA NUNEZ RODRIGUEZ OD
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Gender | Female
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Dates
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Enumeration Date | 10/17/2011
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Last Update Date | 08/02/2024
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Provider Practice Location Address
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Address Line | 2906 MATOMAS
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City | SAN ANTONIO AGUADILLAS
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State | PR
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Zip | 00690-0069
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Country | US
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Telephone | 787-356-8037
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Fax | 888-351-6173
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Provider Business Mailing Address
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Address Line | PO BOX 60401
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City | SAN ANTONIO
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State | PR
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Zip | 00690-9003
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Country | US
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Telephone | 787-356-8037
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Fax | 883-516-1738
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 687
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License Number State | PR
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