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General NPI Number Information
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NPI Number | 1881602464
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Entity Type | Individual
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Provider Name | RICARDO LATIMER O.D.
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Gender | Male
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Dates
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Enumeration Date | 08/03/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | LAS CATALINAS MALL LOCAL # 440
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City | CAGUAS
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State | PR
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Zip | 00725-5200
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Country | US
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Telephone | 787-746-0965
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Fax | 787-746-1309
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Provider Business Mailing Address
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Address Line | HC-67 BOX 89 MANSIONES SIERRA TAINA
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City | BAYAMON
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State | PR
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Zip | 00956-9801
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Country | US
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Telephone | 787-785-0437
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Fax | 787-785-0437
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 311
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License Number State | PR
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