Provider Demographics
NPI:1164577938
Name:OPTICARIBE INC
Entity Type:Organization
Organization Name:OPTICARIBE INC
Other - Org Name:OPTICA Y LAB CARIBE INC
Other - Org Type:Other Name
Authorized Official - Title/Position:OPTICIAN/OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:VICTORIA
Authorized Official - Last Name:DEL PINO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-757-3375
Mailing Address - Street 1:PO BOX 29457
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00929-0457
Mailing Address - Country:US
Mailing Address - Phone:787-757-3375
Mailing Address - Fax:787-757-3375
Practice Address - Street 1:URB COUNTRY CLUB
Practice Address - Street 2:AVE CAMPO RICO #925
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00924
Practice Address - Country:US
Practice Address - Phone:787-757-3375
Practice Address - Fax:787-757-3375
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-24
Last Update Date:2023-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR54911Medicare PIN
PR1013560001Medicare NSC