Provider Demographics
NPI:1164600847
Name:FIDEL J RODRIGUEZ CRUZ
Entity Type:Organization
Organization Name:FIDEL J RODRIGUEZ CRUZ
Other - Org Name:BEST VISION CANOVANAS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OPTICIAN
Authorized Official - Prefix:MR
Authorized Official - First Name:FIDEL
Authorized Official - Middle Name:JOEL
Authorized Official - Last Name:RODRIGUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-256-6060
Mailing Address - Street 1:PO BOX 1270
Mailing Address - Street 2:
Mailing Address - City:CANOVANAS
Mailing Address - State:PR
Mailing Address - Zip Code:00729-1270
Mailing Address - Country:US
Mailing Address - Phone:787-256-6060
Mailing Address - Fax:787-256-6061
Practice Address - Street 1:CARRETERA # 3 KM 19.9
Practice Address - Street 2:EDIFICIO EAST MEDICAL PROFESSIONAL CENTER
Practice Address - City:CANOVANAS
Practice Address - State:PR
Practice Address - Zip Code:00729
Practice Address - Country:US
Practice Address - Phone:787-256-6060
Practice Address - Fax:787-256-6061
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-05
Last Update Date:2014-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes332H00000XSuppliersEyewear Supplier
No152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty
No156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOpticianGroup - Multi-Specialty
No208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty