Provider Demographics
NPI:1386672798
Name:GRUPO ANESTESIOLOGOS DE OJOS
Entity Type:Organization
Organization Name:GRUPO ANESTESIOLOGOS DE OJOS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ANESTHESIA DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:IVAN
Authorized Official - Middle Name:E
Authorized Official - Last Name:LOPEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-722-4025
Mailing Address - Street 1:PO BOX 364089
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00936-4089
Mailing Address - Country:US
Mailing Address - Phone:787-722-2251
Mailing Address - Fax:787-722-2292
Practice Address - Street 1:CALLE HIPODROMO ESQ LAS PALMAS
Practice Address - Street 2:OJOS INC
Practice Address - City:SAN TURCE
Practice Address - State:PR
Practice Address - Zip Code:00908
Practice Address - Country:US
Practice Address - Phone:787-721-8330
Practice Address - Fax:787-722-2292
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-28
Last Update Date:2022-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR84686Medicare ID - Type Unspecified