Provider Demographics
NPI:1174849244
Name:DR. LUIS PADILLA ZAPATA, OPTOMETRA, C.S. P.
Entity Type:Organization
Organization Name:DR. LUIS PADILLA ZAPATA, OPTOMETRA, C.S. P.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CORPORATE PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LUIS
Authorized Official - Middle Name:EDGARDO
Authorized Official - Last Name:PADILLA
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:787-460-1587
Mailing Address - Street 1:PO BOX 9244
Mailing Address - Street 2:
Mailing Address - City:CAROLINA
Mailing Address - State:PR
Mailing Address - Zip Code:00988-9244
Mailing Address - Country:US
Mailing Address - Phone:787-460-1587
Mailing Address - Fax:
Practice Address - Street 1:469 AVE ESMERALDA
Practice Address - Street 2:COND. PLAZA ESMERALDA APTO 263
Practice Address - City:GUAYNABO
Practice Address - State:PR
Practice Address - Zip Code:00969-4280
Practice Address - Country:US
Practice Address - Phone:787-367-8585
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-14
Last Update Date:2010-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305S00000XManaged Care OrganizationsPoint of Service