Organization Name: | VITREO RETINAL CONSULTANTS, PSC |
NPI Number: | 1457497992 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | ROBERT BOADA (PRESIDENT) |
Mailing Address: | 2 Ave. Km 11.3 Bayamon Medical Plaza Suite 810 Bayamon |
State: | PR US |
Postal Code: | 00959 |
Phone Number: | 7872515280 |
Fax Number: | |
NPI Enumeration Date: | 01/30/2007 |
NPI Last Update Date: | 07/02/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | 13255 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | PR |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |