Provider Demographics
NPI:1184788390
Name:OTERO, ELSA IRIS (MA, OD)
Entity type:Individual
Prefix:DR
First Name:ELSA
Middle Name:IRIS
Last Name:OTERO
Suffix:
Gender:F
Credentials:MA, OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30002 VALLE DEL AMANECER
Mailing Address - Street 2:VALLE DORADO
Mailing Address - City:DORADO
Mailing Address - State:PR
Mailing Address - Zip Code:00646
Mailing Address - Country:US
Mailing Address - Phone:787-590-9015
Mailing Address - Fax:
Practice Address - Street 1:30002 VALLE DEL AMANECER
Practice Address - Street 2:VALLE DORADO
Practice Address - City:DORADO
Practice Address - State:PR
Practice Address - Zip Code:00946
Practice Address - Country:US
Practice Address - Phone:787-590-9015
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR423152WL0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152WL0500XEye and Vision Services ProvidersOptometristLow Vision Rehabilitation