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NPI 1932390424

NPI 1932390424 : JEANNETTE MAS O.D. : SAN JUAN, PR

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General NPI Number Information
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    NPI Number           |    1932390424
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    Entity Type          |    Individual 
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    Provider Name        |    JEANNETTE MAS O.D.
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    08/08/2007
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    Last Update Date     |    08/08/2007
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Provider Practice Location Address
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    Address Line         |    CHALETS DE CUPEY BOX 11
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    City                 |    SAN JUAN
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    State                |    PR
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    Zip                  |    00926-4460
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    Country              |    US
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    Telephone            |    787-261-5547
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    Fax                  |    787-261-4896
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Provider Business Mailing Address
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    Address Line         |    CHALETS DE CUPEY BOX 11
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    City                 |    SAN JUAN
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    State                |    PR
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    Zip                  |    00926-4460
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    Country              |    US
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    Telephone            |    787-261-5547
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    Fax                  |    787-261-4896
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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       |    379
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    License Number State |    PR
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