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General NPI Number Information
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NPI Number | 1427488543
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Entity Type | Organization
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Legal Business Name | BARRETO EYE CLINIC
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Dates
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Enumeration Date | 11/27/2013
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Last Update Date | 11/27/2013
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Provider Practice Location Address
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Address Line | 71 CALLE BLANCO SOSA
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City | CANOVANAS
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State | PR
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Zip | 00729-3235
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Country | US
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Telephone | 787-900-3316
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 713
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City | CANOVANAS
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State | PR
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Zip | 00729-0713
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Country | US
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Telephone | 787-900-3316
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Fax |
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Authorized Official
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Title or Position | PRESIDENT / OPTOMETRIST
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Name | DR. AIDA LIZ BARRETO
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Credential | O.D.
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Telephone | 787-900-3316
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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 | 629
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License Number State | PR
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