Individual
DR. MYLTHIA P MATOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
CALLE ANTONIO R BARCELO#8, TOA ALTA, PR 00954
(787) 870-7575
Mailing address
#3 GARDENIA BZ115 CAPE SEA VILLAGE, CAROLINA, PR 00979
(787) 379-9070
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
601
PR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
57770
TRIPLE S
PR
Enumeration date
05/19/2006
Last updated
07/08/2007
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