Provider Demographics
NPI:1801215579
Name:GUAYNABO EYE & EAR GROUP PSC
Entity Type:Organization
Organization Name:GUAYNABO EYE & EAR GROUP PSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:TREASURER
Authorized Official - Prefix:DR
Authorized Official - First Name:RAMON
Authorized Official - Middle Name:R
Authorized Official - Last Name:BERRIOS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-706-4334
Mailing Address - Street 1:PO BOX 1036
Mailing Address - Street 2:
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00970-1036
Mailing Address - Country:US
Mailing Address - Phone:787-706-4334
Mailing Address - Fax:787-749-0993
Practice Address - Street 1:1510 AVE FD ROOSEVELT
Practice Address - Street 2:MEZZANINE SUITE B
Practice Address - City:GUAYNABO
Practice Address - State:PR
Practice Address - Zip Code:00968-2695
Practice Address - Country:US
Practice Address - Phone:787-706-4334
Practice Address - Fax:787-749-0993
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-10
Last Update Date:2020-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
156FX1800X, 231H00000X
PR9651207W00000X
PR11652207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Multi-Specialty
No156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOpticianGroup - Multi-Specialty
No207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Multi-Specialty
No231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Multi-Specialty