Provider Demographics
NPI:1033910732
Name:ULLOA OCULOPLASTIC SURGERY LLC
Entity type:Organization
Organization Name:ULLOA OCULOPLASTIC SURGERY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAN
Authorized Official - Middle Name:PAUL
Authorized Official - Last Name:ULLOA PADILLA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-430-4119
Mailing Address - Street 1:B69 CALLE POPPY
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926-6566
Mailing Address - Country:US
Mailing Address - Phone:787-430-4119
Mailing Address - Fax:
Practice Address - Street 1:525 AVE ROOSEVELT TORRE MEDICA PLAZA LAS AMERICAS
Practice Address - Street 2:OFFICE 406
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00918
Practice Address - Country:US
Practice Address - Phone:787-767-0599
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-20
Last Update Date:2025-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207WX0200XAllopathic & Osteopathic PhysiciansOphthalmologyOphthalmic Plastic and Reconstructive SurgeryGroup - Multi-Specialty