Provider Demographics
NPI:1689795734
Name:PLAZA REFRACTIVE LASER CENTER, INC.
Entity Type:Organization
Organization Name:PLAZA REFRACTIVE LASER CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:DR. EDUARDO
Authorized Official - Middle Name:P
Authorized Official - Last Name:TABOAS PEREZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-767-0599
Mailing Address - Street 1:525 F. D.ROOSEVELT AVE.
Mailing Address - Street 2:SUITE 802, TORRE DE PLAZA LAS AMERICAS
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926
Mailing Address - Country:US
Mailing Address - Phone:787-758-5939
Mailing Address - Fax:787-763-2761
Practice Address - Street 1:525 F. D.ROOSEVELT AVE.
Practice Address - Street 2:SUITE 802, TORRE DE PLAZA LAS AMERICAS
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00926
Practice Address - Country:US
Practice Address - Phone:787-758-5939
Practice Address - Fax:787-763-2761
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-03
Last Update Date:2022-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes156FX1100XEye and Vision Services ProvidersTechnician/TechnologistOphthalmicGroup - Single Specialty
No152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty
No207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Multi-Specialty
No332H00000XSuppliersEyewear SupplierGroup - Single Specialty