Provider Demographics
NPI:1083825475
Name:NOGAL VISUAL CLINIC
Entity Type:Organization
Organization Name:NOGAL VISUAL CLINIC
Other - Org Name:NOGAL VISUAL CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MARY
Authorized Official - Middle Name:
Authorized Official - Last Name:MERCED
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:787-798-1315
Mailing Address - Street 1:URB LOMAS VERDES AVE CARLOS ANDALUZ
Mailing Address - Street 2:4X-2
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00956
Mailing Address - Country:US
Mailing Address - Phone:787-798-1315
Mailing Address - Fax:787-780-5538
Practice Address - Street 1:AVE CARLOS ANDALUZ
Practice Address - Street 2:4X-2 LOMAS VERDES
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00956
Practice Address - Country:US
Practice Address - Phone:787-798-1315
Practice Address - Fax:787-780-5538
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier