Organization Active NPI

Ojos Puerto Rico Retina, PSC

  • Specialist
  • San Juan, PR
National Provider Identifier
1679851406
Registry record updated Jul 27, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
17473 Issued in PR
Legal business name
OJOS PUERTO RICO RETINA, PSC
Practice address
1890 Calle Petunia
Santa Maria
San Juan, PR 00927-6637
Phone
(787) 820-8989
Fax
(787) 820-8989
NPI assigned
Jul 27, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 27, 2011

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

Authorized official

Name
Mrs. Stella M Casillas
Title
Retinologa
Phone
(787) 820-8989

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193200000X MULTI-SPECIALTY GROUP 174400000X 17473 PR Primary

Addresses

Primary practice location

1890 Calle Petunia
Santa Maria
San Juan, PR 00927-6637

Mailing address

300 Ave la Sierra Apt 101
San Juan, PR 00926-4339
Phone (787) 820-8989

Other identifiers 1

IdentifierTypeStateIssuer
17473OtherPRLICENCIA

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1311724800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1311724800000",
    "number": "1679851406",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 AVE LA SIERRA APT 101",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009264339",
            "telephone_number": "787-820-8989",
            "fax_number": "787-820-8989"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1890 CALLE PETUNIA",
            "address_2": "SANTA MARIA",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009276637",
            "telephone_number": "787-820-8989",
            "fax_number": "787-820-8989"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OJOS PUERTO RICO RETINA, PSC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-07-27",
        "last_updated": "2011-07-27",
        "status": "A",
        "authorized_official_last_name": "CASILLAS",
        "authorized_official_first_name": "STELLA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "RETINOLOGA",
        "authorized_official_telephone_number": "787-820-8989",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "PR",
            "license": "17473",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENCIA",
            "identifier": "17473",
            "state": "PR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Juan, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2011; 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.