Provider Demographics
NPI:1659417723
Name:MURATI, GIAN (OD)
Entity Type:Individual
Prefix:
First Name:GIAN
Middle Name:
Last Name:MURATI
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:L7 CALLE TER
Mailing Address - Street 2:GARDEN HILLS
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00966-2120
Mailing Address - Country:US
Mailing Address - Phone:787-379-2020
Mailing Address - Fax:787-798-1895
Practice Address - Street 1:50 CALLE ISABEL II
Practice Address - Street 2:STE 106
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00961-6314
Practice Address - Country:US
Practice Address - Phone:787-786-2000
Practice Address - Fax:787-798-1895
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR195152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR0058128Medicare ID - Type Unspecified
PRU63246Medicare UPIN