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Organization
COROZAL OPTICAL
Active
Organization
COROZAL OPTICAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JESUS M RIVERA (OPTICO)
(787) 689-7856
Entity
Organization
Contact information
Practice address
CARR 159 KM 13.1 LOCAL 5 SALIDA COROZAL A MOROVIS, BLDG 5, COROZAL, PR 00783-0078
(787) 689-7856
Mailing address
CARR 159 KM 13.1 LOCAL 5 SALIDA COROZAL A MOROVIS, BLDG 5, COROZAL, PR 00783-2903
(787) 689-7856
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
—
NULL
207W00000X
Ophthalmology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1992297675
OPTICO
PR
Enumeration date
01/29/2021
Last updated
01/29/2021
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