| |
1000 The Mall Of Sj Boulevard, Suite 118 Urb Villa Olimpia, San Juan, PR 00924-4043 | |
(787) 507-5377 | |
(787) 731-5642 |
Full Name | |
---|---|
Type | Facility |
Speciality | Eyewear Supplier |
Location | 1000 The Mall Of Sj Boulevard, San Juan, Puerto Rico |
Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1144086562 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
152W00000X | Optometrist | (* (Not Available)) | Secondary |
261Q00000X | Clinic/center | (* (Not Available)) | Secondary |
332H00000X | Eyewear Supplier | (* (Not Available)) | Primary |
Mailing Address | Practice Location Address |
---|---|
90 Calle Medici, Urb Paseo Del Parque, San Juan, PR 00924-6514 Ph: (787) 507-5377 | 1000 The Mall Of Sj Boulevard, Suite 118 Urb Villa Olimpia, San Juan, PR 00924-4043 Ph: (787) 507-5377 |