Provider Demographics
NPI:1154683084
Name:INSTITUTO DE OJOS Y PIEL
Entity type:Organization
Organization Name:INSTITUTO DE OJOS Y PIEL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MIS DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:EVELYN
Authorized Official - Middle Name:
Authorized Official - Last Name:PADILLA-ORTEGA
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:CARR #3 KM 12.3
Practice Address - Street 2:AVENIDA 65 INFANTERIA
Practice Address - City:CAROLINA
Practice Address - State:PR
Practice Address - Zip Code:00985-0000
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:2012-06-15
Last Update Date:2024-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR332H00000X, 332H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier