Provider Demographics
NPI:1891974820
Name:INSTITUTO DE OJOS Y CIRUGIA PLASTICA
Entity Type:Organization
Organization Name:INSTITUTO DE OJOS Y CIRUGIA PLASTICA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENTE
Authorized Official - Prefix:
Authorized Official - First Name:LUIS
Authorized Official - Middle Name:A
Authorized Official - Last Name:RIVERA RODRIGUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-252-8316
Mailing Address - Street 1:PO BOX 3241
Mailing Address - Street 2:
Mailing Address - City:MAYAGUEZ
Mailing Address - State:PR
Mailing Address - Zip Code:00681-3241
Mailing Address - Country:US
Mailing Address - Phone:787-252-8316
Mailing Address - Fax:787-252-1216
Practice Address - Street 1:CARR #2 KM 133.5 BO GUANABANO
Practice Address - Street 2:EDF CENTER PLEX
Practice Address - City:AGUADA
Practice Address - State:PR
Practice Address - Zip Code:00602
Practice Address - Country:US
Practice Address - Phone:787-252-8316
Practice Address - Fax:787-252-1216
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-26
Last Update Date:2007-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty