=====================================================
General NPI Number Information
=====================================================
NPI Number | 1659476976
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | LUIS O APONTE OPTOMETRY (OD)
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/13/2006
-----------------------------------------------------
Last Update Date | 08/16/2016
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | MANSIONES REALES, J-3 , PASEO DE LA REINA ST.
-----------------------------------------------------
City | GUAYNABO
-----------------------------------------------------
State | PR
-----------------------------------------------------
Zip | 00969
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 787-789-5429
-----------------------------------------------------
Fax | 787-789-5429
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | ST. PASEO DE LA REINA # J-3 MANSIONES REALES
-----------------------------------------------------
City | GUAYNABO
-----------------------------------------------------
State | PR
-----------------------------------------------------
Zip | 00969
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 787-789-5429
-----------------------------------------------------
Fax | 787-789-5429
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 152WC0802X
-----------------------------------------------------
Taxonomy Name | Corneal and Contact Management Optometrist
-----------------------------------------------------
License Number | 00220-0036
-----------------------------------------------------
License Number State | PR
-----------------------------------------------------