Provider Demographics
NPI:1326312703
Name:PONCE OPTICS CARE, INC
Entity Type:Organization
Organization Name:PONCE OPTICS CARE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT AND CEO
Authorized Official - Prefix:
Authorized Official - First Name:ANGELITA
Authorized Official - Middle Name:
Authorized Official - Last Name:MARTINEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-568-6896
Mailing Address - Street 1:108 CALLE ATOCHA
Mailing Address - Street 2:
Mailing Address - City:PONCE
Mailing Address - State:PR
Mailing Address - Zip Code:00730-3772
Mailing Address - Country:US
Mailing Address - Phone:787-844-2295
Mailing Address - Fax:787-844-2295
Practice Address - Street 1:108 CALLE ATOCHA
Practice Address - Street 2:
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00730-3772
Practice Address - Country:US
Practice Address - Phone:787-844-2295
Practice Address - Fax:787-844-2295
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-01
Last Update Date:2012-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR704332H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier