| Organization Name: | SOUTHWEST OPHTHALMIC CSP |
| NPI Number: | 1144487075 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | DAVID SILVA CARABALLO (OWNER) |
| Mailing Address: | Casto Perez Avenue Rali Bldg Suite 101 San German |
| State: | PR US |
| Postal Code: | 00683 |
| Phone Number: | 7878923340 |
| Fax Number: | 7878925135 |
| NPI Enumeration Date: | 05/19/2008 |
| NPI Last Update Date: | 05/19/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 156FX1100X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Eye and Vision Services Providers |
| Taxonomy Classification: | Technician/Technologist |
| Taxonomy Specialization: | Ophthalmic |
| Taxonomy Definition: | |