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General NPI Number Information
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NPI Number | 1285058198
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Entity Type | Organization
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Legal Business Name | BANCO DE OJOS DEL LEONISMO PUERTORRIQUENO
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Dates
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Enumeration Date | 02/12/2014
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Last Update Date | 02/12/2014
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Provider Practice Location Address
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Address Line | V3-22 AVE SAN ALFONSO URB. LAS LOMAS
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City | SAN JUAN
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State | PR
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Zip | 00921-3608
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Country | US
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Telephone | 787-273-0597
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Fax | 407-499-4655
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Provider Business Mailing Address
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Address Line | PO BOX 363311
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City | SAN JUAN
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State | PR
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Zip | 00936-3311
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Country | US
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Telephone | 787-273-0597
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Fax | 407-499-4655
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MIRIAM VAZQUEZ
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Credential |
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Telephone | 787-273-0597
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332G00000X
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Taxonomy Name | Eye Bank
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License Number | 7349
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License Number State | PR
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