Provider Demographics
NPI:1659111573
Name:ARC OF PR, LLC
Entity type:Organization
Organization Name:ARC OF PR, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:YOUSEF
Authorized Official - Middle Name:
Authorized Official - Last Name:CRUZ INIGO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-342-5349
Mailing Address - Street 1:HC 1 BOX 3143
Mailing Address - Street 2:
Mailing Address - City:COROZAL
Mailing Address - State:PR
Mailing Address - Zip Code:00783-9407
Mailing Address - Country:US
Mailing Address - Phone:787-342-5349
Mailing Address - Fax:
Practice Address - Street 1:CARR 159 KM 15.5
Practice Address - Street 2:
Practice Address - City:COROZAL
Practice Address - State:PR
Practice Address - Zip Code:00783-2903
Practice Address - Country:US
Practice Address - Phone:787-859-8318
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-29
Last Update Date:2024-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207WX0107XAllopathic & Osteopathic PhysiciansOphthalmologyRetina SpecialistGroup - Single Specialty