Provider Demographics
NPI:1932390424
Name:MAS, JEANNETTE (OD)
Entity type:Individual
Prefix:DR
First Name:JEANNETTE
Middle Name:
Last Name:MAS
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:CHALETS DE CUPEY
Mailing Address - Street 2:BOX 11
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926-4460
Mailing Address - Country:US
Mailing Address - Phone:787-261-5547
Mailing Address - Fax:787-261-4896
Practice Address - Street 1:CHALETS DE CUPEY
Practice Address - Street 2:BOX 11
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00926-4460
Practice Address - Country:US
Practice Address - Phone:787-261-5547
Practice Address - Fax:787-261-4896
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-08
Last Update Date:2007-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR379152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist