Doctor Name: | MRS. IDA OTERO |
NPI Number: | 1598061947 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | |
Business Practice Address: | Cond Sierra Bayamon 7-13 North Main Ste. 1 Bayamon, PR - 009614201 |
Business Phone Number: | 7877853374 |
Business Fax Number: | 7877853374 |
Mailing Address: | 243 Calle Rio Cibuco, Urb. Monte Casino Heights TOA ALTA |
State: | PR |
Postal Code: | 009533761 |
Phone Number: | 7877853374 |
Fax Number: | 7877853374 |
NPI Enumeration Date: | 02/02/2011 |
NPI Last Update Date: | 02/02/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 156F00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Eye and Vision Services Providers |
Taxonomy Classification: | Technician/Technologist |
Taxonomy Specialization: | |
Taxonomy Definition: | A broad category grouping different kinds of technologists and technicians. See individual definitions. |