Organization
CONSULTORIO OPTOMETRICO DE SG, CSP
Active
Other names
Dr. Luis E. Mora Antongiorgi
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LUIS E MORA O.D. (OPTOMETRIST/PRESIDENT)
(787) 892-1218
Entity
Organization
Contact information
Practice address
AVE. ANGEL C PEREZ #2, SAN GERMAN, PR 00683
(787) 892-1218
(787) 892-7480
Mailing address
PO BOX 495, SAN GERMAN, PR 00683-0495
(787) 892-1218
(787) 892-7480
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
403-0029
PR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
077-137
CRUZ AZUL
PR
01
—
215264
PREFFERRED HEALTH
PR
01
—
50002
SSS
PR
01
—
5211
IMC
PR
01
—
6830042
HUMANA
PR
01
—
890343
MMM
PR
Enumeration date
08/11/2006
Last updated
08/22/2020
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