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General NPI Number Information
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NPI Number | 1699552349
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Entity Type | Organization
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Legal Business Name | CARIBBEAN OPHTHALMOLOGY ASSOCIATES LLC
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Dates
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Enumeration Date | 09/14/2023
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Last Update Date | 01/16/2024
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Provider Practice Location Address
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Address Line | 1112 AVE JESUS T PINERO
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City | SAN JUAN
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State | PR
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Zip | 00921-1722
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Country | US
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Telephone | 787-781-3020
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Fax |
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Provider Business Mailing Address
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Address Line | 995 CALLE QUITO
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City | SAN JUAN
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State | PR
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Zip | 00921-2337
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Country | US
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Telephone | 787-514-4748
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. EDGAR ALEXIS DE JESUS RODRIGUEZ
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Credential | MD
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Telephone | 787-514-4748
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number |
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License Number State |
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