Provider Demographics
NPI:1376763060
Name:NOVA OPTICAL GROUP CORP
Entity Type:Organization
Organization Name:NOVA OPTICAL GROUP CORP
Other - Org Name:OPTICA PUNTO DE VISTA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NORA
Authorized Official - Middle Name:
Authorized Official - Last Name:ALCOCER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-732-1700
Mailing Address - Street 1:Q1 CALLE SANTA LUCIA
Mailing Address - Street 2:URB. SANTA ELVIRA
Mailing Address - City:CAGUAS
Mailing Address - State:PR
Mailing Address - Zip Code:00725-3440
Mailing Address - Country:US
Mailing Address - Phone:787-732-1700
Mailing Address - Fax:787-732-1700
Practice Address - Street 1:CARR. 174 KM 21
Practice Address - Street 2:BO. MULAS
Practice Address - City:AGUAS BUENAS
Practice Address - State:PR
Practice Address - Zip Code:00703
Practice Address - Country:US
Practice Address - Phone:787-732-1700
Practice Address - Fax:787-732-1700
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR582156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOpticianGroup - Single Specialty