# ADVANCED GLAUCOMA AND OPHTHALMOLOGY SERVICES

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1629465604
- **Authorized official:** DR. NANETTE M DE LEON M.D. (SOLE MEMBER)
- **Authorized official phone:** (787) 717-3068

## Contact information

- **Practice address:** 572 AVE CESAR GONZALEZ, HATO REY, SAN JUAN, PR 00918
- **Practice address phone:** (787) 764-4066
- **Mailing address:** RR 36 BOX 8233, SAN JUAN, PR 00926-9562

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207W00000X | Ophthalmology Physician | 17637 | PR | Yes |

## Other

- **Enumeration date:** 04/17/2015
- **Last updated:** 04/17/2015