Raul Cruz Detres, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

267 Issued in PR

Practice address

Aguadilla Mall
Aguadilla, PR 00603

Phone

(787) 882-0077

Fax

(787) 882-0079

NPI assigned

Oct 20, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in PR

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Family Optical Center Inc.

  dba Family Vision Center

  • Clinic/Center
  • San German, PR
  • NPI 1841231180
  Medicare reassignment NPD
• Family Optical Center Inc.

  dba Family Vision Center

  • Clinic/Center
  • Yauco, PR
  • NPI 1902188295
  NPD (past)

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

{
    "created_epoch": "1161302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1649353137",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3112 AVE JUAN HERNANDEZ ORTIZ",
            "city": "ISABELA",
            "state": "PR",
            "postal_code": "006623614",
            "telephone_number": "787-872-6515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "AGUADILLA MALL",
            "city": "AGUADILLA",
            "state": "PR",
            "postal_code": "00603",
            "telephone_number": "787-882-0077",
            "fax_number": "787-882-0079"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DETRES",
        "first_name": "RAUL",
        "middle_name": "CRUZ",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "PR",
            "license": "267",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Yaritzie Deliz Perez
• Yiznelle Marie Deliz
• Delma Cortez Nieves (Laboratorios Clinico del Mar)
• Ricardo Jose Desa-Cintron, DMD
• Victor Shamir Detres Quiles
• Dalies Deynes Vargas, BAPH
• Diagnostic Nuclear Medicine
• Xiomara Diaz Barreto, MD
• Laura Iris Diaz Pagan, PSY.D
• Erbett Diaz Salva, D.C.

• Optometrist in Aguadilla, PR
• Providers in Aguadilla, PR by specialty
• Optometrist in Puerto Rico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.