Provider Demographics
NPI:1154728962
Name:CONSULTORES OFTALMICOS DEL SUR, INC.
Entity type:Organization
Organization Name:CONSULTORES OFTALMICOS DEL SUR, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JORGE
Authorized Official - Middle Name:
Authorized Official - Last Name:HERNANDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-841-7030
Mailing Address - Street 1:EDIF PARRAS
Mailing Address - Street 2:PONCE BY PASS SUITE 802
Mailing Address - City:PONCE
Mailing Address - State:PR
Mailing Address - Zip Code:00717-1321
Mailing Address - Country:US
Mailing Address - Phone:787-841-7030
Mailing Address - Fax:787-844-1125
Practice Address - Street 1:EDIF PARRAS
Practice Address - Street 2:PONCE BY PASS SUITE 802
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00717-1321
Practice Address - Country:US
Practice Address - Phone:787-841-7030
Practice Address - Fax:787-844-1125
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-21
Last Update Date:2014-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Multi-Specialty