Organization Active NPI

Specialized Eye Institute, LLC

  • Retina Specialist (Ophthalmology) Physician
  • Dorado, PR
National Provider Identifier
1639966393
Registry record updated Apr 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Retina Specialist (Ophthalmology) PhysicianTaxonomy code 207WX0107X
Legal business name
SPECIALIZED EYE INSTITUTE, LLC
Practice address
410 Calle Mendez Vigo
Dorado, PR 00646-4800
Phone
(787) 796-4155
NPI assigned
Apr 24, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2025

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

Authorized official

Name
Pedro J Davila, MDNPI 1265852040
Title
President
Phone
(787) 604-5429

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Retina Specialist (Ophthalmology) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207WX0107X Primary
Neuro-ophthalmology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207WX0109X
Pediatric Ophthalmology and Strabismus Specialist PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207WX0110X

Addresses

Primary practice location

410 Calle Mendez Vigo
Dorado, PR 00646-4800

Mailing address

PO Box 317
Dorado, PR 00646-0317

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250606002752 PR Part B Supplier - Clinic/Group Practice 0941710149 Receives reassigned benefits from 3 practitioners
Practice locations: Bayamon, PR; Dorado, PR; Guaynabo, PR; Manati, PR

National Provider Directory

National Provider Directory

Interoperability endpoints

  • Direct secure messaging: mviladelgado@davila.intellechartdirect.net
  • Direct secure messaging: pdavila@davila.intellechartdirect.net

Practitioners & affiliated clinicians

Practitioners 3

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

NPI Registry JSON

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

{
    "created_epoch": "1745452800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1745452800000",
    "number": "1639966393",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 317",
            "city": "DORADO",
            "state": "PR",
            "postal_code": "006460317"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 CALLE MENDEZ VIGO",
            "city": "DORADO",
            "state": "PR",
            "postal_code": "006464800",
            "telephone_number": "787-796-4155"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPECIALIZED EYE INSTITUTE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-04-24",
        "last_updated": "2025-04-24",
        "certification_date": "2025-04-24",
        "status": "A",
        "authorized_official_last_name": "DAVILA",
        "authorized_official_first_name": "PEDRO",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "787-604-5429",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207WX0107X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Ophthalmology, Retina Specialist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207WX0109X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Ophthalmology, Neuro-ophthalmology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207WX0110X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Ophthalmology, Pediatric Ophthalmology and Strabismus Specialist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dorado, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.