Provider Demographics
NPI:1225010721
Name:ARAMBURU DIAZ, LUIS (OD)
Entity Type:Individual
Prefix:MR
First Name:LUIS
Middle Name:
Last Name:ARAMBURU DIAZ
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:59 AVE ESMERALDA
Mailing Address - Street 2:LOCAL 2
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00969-4429
Mailing Address - Country:US
Mailing Address - Phone:787-790-3848
Mailing Address - Fax:787-765-7035
Practice Address - Street 1:1122 AVE PONCE DE LEON
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00925-2908
Practice Address - Country:US
Practice Address - Phone:787-790-3848
Practice Address - Fax:787-765-7035
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-18
Last Update Date:2011-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR215152WL0500X
PROD215152WL0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152WL0500XEye and Vision Services ProvidersOptometristLow Vision Rehabilitation