Provider Demographics
NPI:1265059554
Name:INTER AMERICAN UNIVERSITY OF PUERTO RICO
Entity type:Organization
Organization Name:INTER AMERICAN UNIVERSITY OF PUERTO RICO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DEAN
Authorized Official - Prefix:
Authorized Official - First Name:ANDRES
Authorized Official - Middle Name:
Authorized Official - Last Name:PAGAN
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:787-765-1915
Mailing Address - Street 1:500 CARR DR JOHN W HARRIS
Mailing Address - Street 2:
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00957-6257
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:500 CARR DR JOHN W HARRIS
Practice Address - Street 2:
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00957-6257
Practice Address - Country:US
Practice Address - Phone:787-765-1915
Practice Address - Fax:787-765-9854
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:INTER AMERICAN UNIVERSITY OF PUERTO RICO
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-07-02
Last Update Date:2020-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty