Provider Demographics
NPI:1407218340
Name:ANTEOJOS INC.
Entity Type:Organization
Organization Name:ANTEOJOS INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:DIANELLY
Authorized Official - Middle Name:STEPHANIE
Authorized Official - Last Name:POU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-431-8814
Mailing Address - Street 1:PO BOX 1984
Mailing Address - Street 2:
Mailing Address - City:MAYAGUEZ
Mailing Address - State:PR
Mailing Address - Zip Code:00681-1984
Mailing Address - Country:US
Mailing Address - Phone:787-431-8814
Mailing Address - Fax:787-805-4461
Practice Address - Street 1:23 CALLE LA CANDELARIA OESTE
Practice Address - Street 2:
Practice Address - City:MAYAGUEZ
Practice Address - State:PR
Practice Address - Zip Code:00680
Practice Address - Country:US
Practice Address - Phone:787-431-8814
Practice Address - Fax:787-805-4461
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-21
Last Update Date:2016-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOpticianGroup - Single Specialty