Provider Demographics
NPI:1962427286
Name:BARROSO-HERRANS, ELSA G (OD)
Entity type:Individual
Prefix:DR
First Name:ELSA
Middle Name:G
Last Name:BARROSO-HERRANS
Suffix:
Gender:F
Credentials:OD
Other - Prefix:DR
Other - First Name:ELSA
Other - Middle Name:G,
Other - Last Name:BARROSO-HERRANS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:OD
Mailing Address - Street 1:S28 CALLE R MENENDEZ PIDAL
Mailing Address - Street 2:EL SENORIAL
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926-6921
Mailing Address - Country:US
Mailing Address - Phone:787-641-7582
Mailing Address - Fax:787-641-9533
Practice Address - Street 1:10 CALLE CASIA
Practice Address - Street 2:VAMC
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00921-3200
Practice Address - Country:US
Practice Address - Phone:787-641-7582
Practice Address - Fax:787-641-9533
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-13
Last Update Date:2017-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR189152WL0500X, 152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
No152WL0500XEye and Vision Services ProvidersOptometristLow Vision Rehabilitation