# COROZAL OPTICAL

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

## Provider details

- **NPI number:** 1699366955
- **Authorized official:** MR. JESUS M RIVERA (OPTICO)
- **Authorized official phone:** (787) 689-7856

## Contact information

- **Practice address:** CARR 159 KM 13.1 LOCAL 5 SALIDA COROZAL A MOROVIS, BLDG 5, COROZAL, PR 00783-0078
- **Practice address phone:** (787) 689-7856
- **Mailing address:** CARR 159 KM 13.1 LOCAL 5 SALIDA COROZAL A MOROVIS, BLDG 5, COROZAL, PR 00783-2903
- **Mailing address phone:** (787) 689-7856

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207W00000X | Ophthalmology Physician | — | NULL | Yes |
| 207W00000X | Ophthalmology Physician | — | — | Yes |

## Other

- **Enumeration date:** 01/29/2021
- **Last updated:** 01/29/2021

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 1992297675 | OPTICO | PR |