Provider Demographics
NPI:1740596915
Name:EYESPOT, LLC
Entity Type:Organization
Organization Name:EYESPOT, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JORGE
Authorized Official - Middle Name:GUILLERMO
Authorized Official - Last Name:ARROYO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:617-650-4324
Mailing Address - Street 1:1 BOYLSTON ST
Mailing Address - Street 2:SUITE 3D
Mailing Address - City:CHESTNUT HILL
Mailing Address - State:MA
Mailing Address - Zip Code:02467-1719
Mailing Address - Country:US
Mailing Address - Phone:617-650-4324
Mailing Address - Fax:
Practice Address - Street 1:1 BOYLSTON ST
Practice Address - Street 2:SUITE 3D
Practice Address - City:CHESTNUT HILL
Practice Address - State:MA
Practice Address - Zip Code:02467-1719
Practice Address - Country:US
Practice Address - Phone:617-650-4324
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-26
Last Update Date:2011-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA154668207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA3167712Medicaid
MA6502950001OtherPROVIDER TRANSACTION ACCESS NUMBER
MAG20287Medicare UPIN