Provider Demographics
NPI:1740014794
Name:BRIGHT RETINA PRACTICE PR LLC
Entity type:Organization
Organization Name:BRIGHT RETINA PRACTICE PR LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KATHLEEN
Authorized Official - Middle Name:
Authorized Official - Last Name:GUERRERO FIGUEREO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-299-2367
Mailing Address - Street 1:PO BOX 519
Mailing Address - Street 2:
Mailing Address - City:HUMACAO
Mailing Address - State:PR
Mailing Address - Zip Code:00792-0519
Mailing Address - Country:US
Mailing Address - Phone:787-366-6839
Mailing Address - Fax:787-421-7613
Practice Address - Street 1:125 CALLE FONT MARTELO E
Practice Address - Street 2:
Practice Address - City:HUMACAO
Practice Address - State:PR
Practice Address - Zip Code:00791-0000
Practice Address - Country:US
Practice Address - Phone:787-852-6825
Practice Address - Fax:787-421-7613
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-30
Last Update Date:2025-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty