Provider Demographics
NPI:1932119922
Name:RETINA CONSULTANTS OF P.R.
Entity Type:Organization
Organization Name:RETINA CONSULTANTS OF P.R.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENTE
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:A
Authorized Official - Last Name:TOWNSEND-PICO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-296-0870
Mailing Address - Street 1:PMB 441 1353 RD 19
Mailing Address - Street 2:
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00966-2700
Mailing Address - Country:US
Mailing Address - Phone:787-296-0870
Mailing Address - Fax:787-771-9789
Practice Address - Street 1:735 AVE PONCE DE LEON
Practice Address - Street 2:TORRE AUXILIO MUTUO, SUITE 502
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00917-5022
Practice Address - Country:US
Practice Address - Phone:787-296-0780
Practice Address - Fax:787-771-9789
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-09
Last Update Date:2008-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty