Provider Demographics
NPI:1891973731
Name:VAM EYEMD, CSP
Entity Type:Organization
Organization Name:VAM EYEMD, CSP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:VICENTE
Authorized Official - Middle Name:
Authorized Official - Last Name:ALCARAZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-758-2404
Mailing Address - Street 1:PO BOX 191168
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00919-1168
Mailing Address - Country:US
Mailing Address - Phone:787-758-2404
Mailing Address - Fax:787-764-4227
Practice Address - Street 1:CALLE CESAR GONZALEZ # 572
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00918-3901
Practice Address - Country:US
Practice Address - Phone:787-758-2404
Practice Address - Fax:787-764-4227
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-02
Last Update Date:2008-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR6117261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty