Provider Demographics
NPI:1487041968
Name:EN OPHTHALMOLOGY SERVICES P S C
Entity Type:Organization
Organization Name:EN OPHTHALMOLOGY SERVICES P S C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:EDGARDO
Authorized Official - Middle Name:
Authorized Official - Last Name:NEGRON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-884-3980
Mailing Address - Street 1:PO BOX 192829
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00919-2829
Mailing Address - Country:US
Mailing Address - Phone:787-884-3980
Mailing Address - Fax:787-884-4479
Practice Address - Street 1:E1 CALLE FERNANDEZ VANGA SUITE 2
Practice Address - Street 2:SAN SALVADOR
Practice Address - City:MANATI
Practice Address - State:PR
Practice Address - Zip Code:00674
Practice Address - Country:US
Practice Address - Phone:787-884-3980
Practice Address - Fax:787-884-4479
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-22
Last Update Date:2015-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR15105207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty