Provider Demographics
NPI:1922555382
Name:CENTRO DE CIRUGIA REFRACTIVA DEL OESTE
Entity Type:Organization
Organization Name:CENTRO DE CIRUGIA REFRACTIVA DEL OESTE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:RICARDO
Authorized Official - Middle Name:MIGUEL
Authorized Official - Last Name:SANTAELLA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-834-2558
Mailing Address - Street 1:PO BOX 1917
Mailing Address - Street 2:
Mailing Address - City:MAYAGUEZ
Mailing Address - State:PR
Mailing Address - Zip Code:00681-1917
Mailing Address - Country:US
Mailing Address - Phone:787-834-2558
Mailing Address - Fax:787-265-7925
Practice Address - Street 1:61 CALLE MENDEZ VIGO ESTE
Practice Address - Street 2:BAJOS
Practice Address - City:MAYAGUEZ
Practice Address - State:PR
Practice Address - Zip Code:00680
Practice Address - Country:US
Practice Address - Phone:787-834-2558
Practice Address - Fax:787-265-7925
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-02
Last Update Date:2016-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR340234261QS0132X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS0132XAmbulatory Health Care FacilitiesClinic/CenterOphthalmologic Surgery