Organization
ADVANCED RETINA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAN CARLOS ORTIZ ROSARIO MD (PRESIDENT)
(787) 432-4849
Entity
Organization
Contact information
Practice address
CALLE UNION #91 ESQ CALLE SOL, PONCE, PR 00730
(787) 848-5353
Mailing address
PO BOX 7432, PONCE, PR 00732-7432
(787) 432-4849
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
—
—
207WX0107X
Retina Specialist (Ophthalmology) Physician
Primary
—
—
Other
Enumeration date
07/01/2022
Last updated
06/21/2023
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