Provider Demographics
NPI:1023052685
Name:INSTITUTO DE OJOS Y PIEL, INC
Entity type:Organization
Organization Name:INSTITUTO DE OJOS Y PIEL, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MIS DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:EVELYN
Authorized Official - Middle Name:
Authorized Official - Last Name:PADILLA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-769-2477
Mailing Address - Street 1:PO BOX 190990
Mailing Address - Street 2:HATO REY STATION
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00919-0990
Mailing Address - Country:US
Mailing Address - Phone:787-769-2477
Mailing Address - Fax:787-276-0065
Practice Address - Street 1:ROAD # 3 KM12.3
Practice Address - Street 2:65 AVENUE
Practice Address - City:CAROLINA
Practice Address - State:PR
Practice Address - Zip Code:00985
Practice Address - Country:US
Practice Address - Phone:787-769-2477
Practice Address - Fax:787-276-0065
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-15
Last Update Date:2024-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR92-130261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR18853Medicare ID - Type UnspecifiedGRUPO ASC