Advanced Glaucoma and Ophthalmology Services

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

17637 Issued in PR

Legal business name

ADVANCED GLAUCOMA AND OPHTHALMOLOGY SERVICES

Practice address

572 Ave Cesar Gonzalez
Hato Rey
San Juan, PR 00918

Phone

(787) 764-4066

NPI assigned

Apr 17, 2015

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Nanette M De Leon, M.D.NPI 1487819256

Title

Sole Member

Phone

(787) 717-3068

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Nanette Michelle De Leon, M.D.

  • Ophthalmology Physician
  • San Juan, PR
  • NPI 1487819256
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1429228800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1429228800000",
    "number": "1629465604",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "RR 36 BOX 8233",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009269562"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "572 AVE CESAR GONZALEZ",
            "address_2": "HATO REY",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "00918",
            "telephone_number": "787-764-4066"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED GLAUCOMA AND OPHTHALMOLOGY SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-04-17",
        "last_updated": "2015-04-17",
        "status": "A",
        "authorized_official_last_name": "DE LEON",
        "authorized_official_first_name": "NANETTE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "SOLE MEMBER",
        "authorized_official_telephone_number": "787-717-3068",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": "PR",
            "license": "17637",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Advanced Cardiovascular Imaging PCS
• Advanced Glaucoma Care
• Advanced Internal Medicine & Cardiovascular Center of P.R. P.S.C
• Advanced Prenatal Diagnosis LLC
• Advanced Professional OB/GYN, PSC
• Advanced Psychoeducational Services Inc

• Ophthalmology Physician in San Juan, PR
• Providers in San Juan, PR by specialty
• Ophthalmology Physician in Puerto Rico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.