Provider Demographics
NPI:1275747446
Name:EYE CARE OPTICAL
Entity Type:Organization
Organization Name:EYE CARE OPTICAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROPIETOR
Authorized Official - Prefix:
Authorized Official - First Name:YAISA
Authorized Official - Middle Name:Z
Authorized Official - Last Name:RUIZ
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:787-262-6014
Mailing Address - Street 1:PO BOX 163
Mailing Address - Street 2:
Mailing Address - City:HATILLO
Mailing Address - State:PR
Mailing Address - Zip Code:00659-0163
Mailing Address - Country:US
Mailing Address - Phone:787-262-6014
Mailing Address - Fax:787-820-7871
Practice Address - Street 1:73 CALLE PH HERNANDEZ
Practice Address - Street 2:
Practice Address - City:HATILLO
Practice Address - State:PR
Practice Address - Zip Code:00659-2007
Practice Address - Country:US
Practice Address - Phone:787-262-6014
Practice Address - Fax:787-820-7871
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-09
Last Update Date:2008-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR616332H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier