Xiomara Ivellisse Matos O.D.

NPI 1376577916 - Optometrist - 152W00000X

NPI Details
NPI 1376577916
Gender Female
Enumeration Date 07/10/2006
Last Updated 07/08/2007
Entity Type Individual
Active Over 10 years ago
Practice Location
CARR. 2 KM 84.2
Phone (787) 820-5378
Fax (787) 820-5409
Business Location
PO BOX 194332
SAN JUAN PR, 00919-4332, US
Phone (787) 644-0957
Fax (787) 622-0788
Taxonomy Code 152W00000X
License State Puerto Rico
License Number 579
Remove 1376577916 NPI Number

According to our database, Xiomara Ivellisse Matos O.D. NPI is 1376577916, taxonomy code is 152W00000X and license number is 579, license state is located at Puerto Rico. Xiomara Ivellisse Matos O.D. physically located at Carr. 2 Km 84.2, Hatillo PR, 00659. NPI Number Xiomara Ivellisse Matos O.D. has the Individual type.

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1376577916 NPI number is provided on an as is basis without warranty of any kind. 1376577916 is maintained by the National Plan & Provider Enumeration System. The contents of Xiomara Ivellisse Matos O.D. are for informational purposes only.