Organization
GLAUCOMA SPECIALISTS OF PUERTO RICO LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CARLOS J VIVES ALVARADO MD (SOLE OWNER)
(787) 485-3480
Entity
Organization
Contact information
Practice address
AVE. DE DIEGO 369, TORRE SAN FRANCISCO SUITE 310, RIO PIEDRAS, PR 00923
(787) 767-8872
Mailing address
URB LOS PASEOS, 1 PASEO SERENO, SAN JUAN, PR 00926-6469
(787) 485-3480
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
—
—
207WX0009X
Glaucoma Specialist (Ophthalmology) Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1902207459
—
PR
01
—
21279
STATE LICENCE
PR
Enumeration date
01/05/2022
Last updated
10/19/2022
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