Provider Demographics
NPI:1164165585
Name:DESIGNER EYES PLA LLC
Entity Type:Organization
Organization Name:DESIGNER EYES PLA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MARKET CLINICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:DAPHINE
Authorized Official - Middle Name:
Authorized Official - Last Name:APONTE
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:813-820-8558
Mailing Address - Street 1:1000 MALL OF SAN JUAN BLVD.
Mailing Address - Street 2:STORE #140
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00924
Mailing Address - Country:US
Mailing Address - Phone:787-490-0085
Mailing Address - Fax:
Practice Address - Street 1:525 FRANKLIN D. ROOSEVELT AVE.
Practice Address - Street 2:PLAZA LAS AMERICAS, SPACE #018
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00918-8001
Practice Address - Country:US
Practice Address - Phone:787-592-3220
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-14
Last Update Date:2022-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier