Provider Demographics
NPI:1720544919
Name:HUMACAO EYE SERVICES, LLC
Entity Type:Organization
Organization Name:HUMACAO EYE SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:L
Authorized Official - Last Name:BENITEZ APONTE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-852-6825
Mailing Address - Street 1:PO BOX 8809
Mailing Address - Street 2:
Mailing Address - City:HUMACAO
Mailing Address - State:PR
Mailing Address - Zip Code:00792-8809
Mailing Address - Country:US
Mailing Address - Phone:787-852-6825
Mailing Address - Fax:787-850-5005
Practice Address - Street 1:15 AVE PADRE RIVERA
Practice Address - Street 2:
Practice Address - City:HUMACAO
Practice Address - State:PR
Practice Address - Zip Code:00791
Practice Address - Country:US
Practice Address - Phone:787-850-5005
Practice Address - Fax:787-850-6825
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-13
Last Update Date:2019-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Multi-Specialty