Provider Demographics
NPI:1295816395
Name:SUAREZ-CASTRO, CARMEN M (OD)
Entity Type:Individual
Prefix:DR
First Name:CARMEN
Middle Name:M
Last Name:SUAREZ-CASTRO
Suffix:
Gender:F
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:AVE. DOMENECH 369
Mailing Address - Street 2:
Mailing Address - City:HATO REY
Mailing Address - State:PR
Mailing Address - Zip Code:00918
Mailing Address - Country:US
Mailing Address - Phone:787-754-0814
Mailing Address - Fax:787-756-5823
Practice Address - Street 1:369 AVE DOMENECH
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00918-3708
Practice Address - Country:US
Practice Address - Phone:787-754-0814
Practice Address - Fax:787-756-5823
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR193152WL0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152WL0500XEye and Vision Services ProvidersOptometristLow Vision Rehabilitation
Provider Identifiers
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PR077108OtherPROVIDER CRUZ AZUL