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General NPI Number Information
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NPI Number | 1629850029
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Entity Type | Organization
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Legal Business Name | OPA OCULOPLASTIC ANESTHESIA LLC
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Dates
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Enumeration Date | 10/19/2023
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Last Update Date | 10/19/2023
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Provider Practice Location Address
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Address Line | MEDICAL OPHTALMIC PLAZA 1875 CARR 2 SUITE 303
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City | BAYAMON
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State | PR
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Zip | 00959
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Country | US
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Telephone | 787-780-0404
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Fax |
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Provider Business Mailing Address
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Address Line | 400 CALLE UNION APT 204, CASA MAGGIORE
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City | GUAYNABO
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State | PR
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Zip | 00969
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Country | US
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Telephone | 787-318-6451
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Fax |
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Authorized Official
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Title or Position | ADMINISTRADORA
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Name | MRS. NILDA LUNA
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Credential |
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Telephone | 787-318-6451
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207LP2900X
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Taxonomy Name | Pain Medicine (Anesthesiology) Physician
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License Number |
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License Number State |
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