Provider Demographics
NPI:1942560271
Name:INFINITY LASER PSC
Entity Type:Organization
Organization Name:INFINITY LASER PSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:VIVIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:CRUZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-775-2020
Mailing Address - Street 1:CARR 165 # KM1
Mailing Address - Street 2:SUITE 117 CITY VIEW PLAZA
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00968-8058
Mailing Address - Country:US
Mailing Address - Phone:787-775-2020
Mailing Address - Fax:787-775-2010
Practice Address - Street 1:CARR 165 KM 1.2 #48
Practice Address - Street 2:SUITE 117 CITY VIEW PLAZA
Practice Address - City:GUAYNABO
Practice Address - State:PR
Practice Address - Zip Code:00968-8047
Practice Address - Country:US
Practice Address - Phone:787-775-2020
Practice Address - Fax:787-775-2010
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-21
Last Update Date:2013-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty