Provider Demographics
NPI:1689897423
Name:TOTTI VERCHER, LUIS JOSE (OD)
Entity Type:Individual
Prefix:DR
First Name:LUIS
Middle Name:JOSE
Last Name:TOTTI VERCHER
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:PO BOX 192971
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00919-2971
Mailing Address - Country:US
Mailing Address - Phone:787-852-1155
Mailing Address - Fax:787-852-1155
Practice Address - Street 1:353 CALLE FONT MARTELO STE 2
Practice Address - Street 2:
Practice Address - City:HUMACAO
Practice Address - State:PR
Practice Address - Zip Code:00791-3225
Practice Address - Country:US
Practice Address - Phone:787-852-1155
Practice Address - Fax:787-852-1155
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-10
Last Update Date:2011-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR253152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR7910006OtherHUMANA
PR58098TOOtherSSS
PR00080OtherVISION HEMISFERICA
PR077126OtherCRUZ AZUL
PR5-8098TOOtherMEDICARE OPTIMO
PR4201OtherAHM
PR215095OtherPREFERRED
PR5-8098TOOtherMEDICARE OPTIMO