Provider Demographics
NPI:1275952897
Name:AGUADILLA OPTICAL EYE
Entity Type:Organization
Organization Name:AGUADILLA OPTICAL EYE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MEICY
Authorized Official - Middle Name:SOFIBEL
Authorized Official - Last Name:VARGAS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-882-0303
Mailing Address - Street 1:PO BOX 250479
Mailing Address - Street 2:BO. VICTORIA
Mailing Address - City:AGUADILLA
Mailing Address - State:PR
Mailing Address - Zip Code:00604-0479
Mailing Address - Country:US
Mailing Address - Phone:787-882-0303
Mailing Address - Fax:787-882-2866
Practice Address - Street 1:AVE VICTORIA ROAD #2 KM 129.3
Practice Address - Street 2:
Practice Address - City:AGUADILLA
Practice Address - State:PR
Practice Address - Zip Code:00604-0479
Practice Address - Country:US
Practice Address - Phone:787-882-0303
Practice Address - Fax:787-882-0399
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-10
Last Update Date:2014-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
No332H00000XSuppliersEyewear SupplierGroup - Single Specialty