Provider Demographics
NPI:1508073297
Name:CARIBBEAN RETINA CONSULTANTS PSC
Entity Type:Organization
Organization Name:CARIBBEAN RETINA CONSULTANTS PSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MISS
Authorized Official - First Name:CRISTINA
Authorized Official - Middle Name:
Authorized Official - Last Name:PENA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-961-4636
Mailing Address - Street 1:PMB 644
Mailing Address - Street 2:1353, RD 19
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00966
Mailing Address - Country:US
Mailing Address - Phone:787-961-4636
Mailing Address - Fax:787-653-3724
Practice Address - Street 1:HIMA PLAZA 1, SUITE 400
Practice Address - Street 2:AVE. DEGETAU
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00725
Practice Address - Country:US
Practice Address - Phone:787-961-4636
Practice Address - Fax:787-653-3724
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-16
Last Update Date:2013-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR=========OtherEIN