Provider Demographics
NPI:1023542396
Name:LLUCH, MYRIAM J
Entity Type:Individual
Prefix:MRS
First Name:MYRIAM
Middle Name:J
Last Name:LLUCH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:A29-2 CALLE MANUELA WALKER
Mailing Address - Street 2:URB ROLLING HILLS CARR 860
Mailing Address - City:CAROLINA
Mailing Address - State:PR
Mailing Address - Zip Code:00987
Mailing Address - Country:US
Mailing Address - Phone:787-242-1920
Mailing Address - Fax:
Practice Address - Street 1:A29-2 CALLE MANUELA WALKER
Practice Address - Street 2:URB ROLLING HILLS CARR 860
Practice Address - City:CAROLINA
Practice Address - State:PR
Practice Address - Zip Code:00987
Practice Address - Country:US
Practice Address - Phone:787-242-1920
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-13
Last Update Date:2017-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician