Provider Demographics
NPI:1346573458
Name:LOVE YOUR EYES OPTICALINC
Entity Type:Organization
Organization Name:LOVE YOUR EYES OPTICALINC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RUTH
Authorized Official - Middle Name:M
Authorized Official - Last Name:ORTIZ
Authorized Official - Suffix:
Authorized Official - Credentials:OPTOMETRIST
Authorized Official - Phone:787-603-3601
Mailing Address - Street 1:CARR 861 # KM6.4
Mailing Address - Street 2:
Mailing Address - City:TOA ALTA
Mailing Address - State:PR
Mailing Address - Zip Code:00953-8528
Mailing Address - Country:US
Mailing Address - Phone:787-603-3601
Mailing Address - Fax:
Practice Address - Street 1:EMMANUELLI 215
Practice Address - Street 2:DAVILA Y LLENZA
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00917
Practice Address - Country:US
Practice Address - Phone:787-603-3601
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-09
Last Update Date:2009-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR456332H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier