MEDICARE: CAIEPA, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152WL0500X	Low Vision Rehabilitation Optometrist	110	PR

General Provider Information

NPI Number	:	1225267420
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CAIEPA, INC.

Provider Business Mailing Address
First Line	:	359 CALLE SAN CLAUDIO
Second Line	:	SUITE 305-B
City	:	SAN JUAN
State	:	PR
Zip	:	00926-9907
Country	:	US
Telephone Number	:	787-460-1587
Fax Number	:

Provider Business Practice Location Address
First Line	:	359 CALLE SAN CLAUDIO
Second Line	:	SUITE 305-B
City	:	SAN JUAN
State	:	PR
Zip	:	00926-9907
Country	:	US
Telephone Number	:	787-460-1587
Fax Number	:

Authorized Official
Title or Position	:	CORPORATE PRESIDENT
Name	:	DR. LUIS PADILLA ZAPATA
Credential	:	O.D.
Telephone Number	:	787-460-1587

Provider Enumeration Date	:	07/08/2009
Last Update Date	:	08/12/2009

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