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NPI Code Detail

MEDICARE: EYE CARE OF SAN JUAN P S C

MEDICARE: EYE CARE OF SAN JUAN P S C
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
1207W00000XOphthalmology Physician9085PR

General Provider Information

NPI Number : 1659689875
Entity Type Code : Organization
Provider Name (Legal Business Name) : EYE CARE OF SAN JUAN P S C
Provider Business Mailing Address
First Line : PO BOX 13953
Second Line :
City : SAN JUAN
State : PR
Zip : 00908-3953
Country : US
Telephone Number : 787-289-6600
Fax Number : 787-289-6622
Provider Business Practice Location Address
First Line : 357 AVE DE LA CONSTITUCION
Second Line : PUERTA DE TIERRA
City : SAN JUAN
State : PR
Zip : 00901-2208
Country : US
Telephone Number : 787-289-6600
Fax Number : 787-289-6622
Authorized Official
Title or Position : ADMINISTRATOR
Name : LOLITA DELATORRE
Credential :
Telephone Number : 787-289-6600
Provider Enumeration Date : 09/22/2010
Last Update Date : 11/03/2011

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Directions to “EYE CARE OF SAN JUAN P S C ” Practice Location

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