Individual
ISAMAR DORTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
CARRIZALEZ WALLMART PLAZA DEL NORTE, CARR # 2 KM.81.9 BO. CARRIZALEZ, HATILLO, PR 00659
(787) 817-2160
Mailing address
HC 4 BOX 43001, HATILLO, PR 00659-9434
(787) 614-3373
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
625
PR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2533496
LICENSE
PR
Enumeration date
08/22/2006
Last updated
07/08/2007
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