| Organization Name: | CLINICA DE OJOS DE GUAYAMA INC |
| NPI Number: | 1053551929 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | ERICBERTO COTTO (OPTOMETRIEST/PRESIDENT) |
| Mailing Address: | Commerce Plaza Urb. Costa Azul Suite 101 G Calle 13 Esq Calle 11 Guayama |
| State: | PR US |
| Postal Code: | 00784 |
| Phone Number: | 7878647902 |
| Fax Number: | 7878647902 |
| NPI Enumeration Date: | 03/04/2009 |
| NPI Last Update Date: | 03/04/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QC1800X |
| License Number: | 471 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | PR |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Corporate Health |
| Taxonomy Definition: | |