Provider Demographics
NPI:1306801550
Name:UNDERWOOD, ANOUK (OD)
Entity type:Individual
Prefix:DR
First Name:ANOUK
Middle Name:
Last Name:UNDERWOOD
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:ANOUK
Other - Middle Name:MICHELLE
Other - Last Name:UNDERWOOD
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:OD
Mailing Address - Street 1:EDIFICIO FAMMA
Mailing Address - Street 2:PMB 345 AVE ASHFOR 1357
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00907-1111
Mailing Address - Country:US
Mailing Address - Phone:787-513-4187
Mailing Address - Fax:787-258-8225
Practice Address - Street 1:PROFESIONAL HOSPITAL NUM 10
Practice Address - Street 2:AVE LAS CUMBRES SUITE 104
Practice Address - City:GUAYNABO
Practice Address - State:PR
Practice Address - Zip Code:00969-1111
Practice Address - Country:US
Practice Address - Phone:787-513-4187
Practice Address - Fax:787-258-8225
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-19
Last Update Date:2025-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR600152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist