| |
1492 Ave Ponce De Leon, Centro Europa Suite 108, San Juan, PR 00907-4012 | |
(787) 723-2253 | |
(787) 724-0163 |
Full Name | |
---|---|
Type | Facility |
Speciality | Eyewear Supplier |
Location | 1492 Ave Ponce De Leon, San Juan, Puerto Rico |
Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1194866566 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
152W00000X | Optometrist | (* (Not Available)) | Secondary |
332H00000X | Eyewear Supplier | (* (Not Available)) | Primary |
Mailing Address | Practice Location Address |
---|---|
Po Box 13311, San Juan, PR 00908-3311 Ph: (787) 723-2253 | 1492 Ave Ponce De Leon, Centro Europa Suite 108, San Juan, PR 00907-4012 Ph: (787) 723-2253 |