Provider Demographics
NPI:1043946023
Name:20/20 OPTICAL, JEIRA INC.
Entity Type:Organization
Organization Name:20/20 OPTICAL, JEIRA INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:IRASEMA
Authorized Official - Middle Name:
Authorized Official - Last Name:LABOY
Authorized Official - Suffix:
Authorized Official - Credentials:OP
Authorized Official - Phone:787-714-4550
Mailing Address - Street 1:55 JOSE DE DIEGO
Mailing Address - Street 2:
Mailing Address - City:CIDRA
Mailing Address - State:PR
Mailing Address - Zip Code:00739-3241
Mailing Address - Country:US
Mailing Address - Phone:787-714-4550
Mailing Address - Fax:877-408-9167
Practice Address - Street 1:CALLE CELIS AGUILERA #22
Practice Address - Street 2:
Practice Address - City:SANTA ISABEL
Practice Address - State:PR
Practice Address - Zip Code:00757
Practice Address - Country:US
Practice Address - Phone:939-717-3277
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:20/20 OPTICAL, JEIRA INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-08-01
Last Update Date:2022-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty