Provider Demographics
NPI:1417673419
Name:LK OPTICS LLC
Entity Type:Organization
Organization Name:LK OPTICS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:KIARA
Authorized Official - Middle Name:E
Authorized Official - Last Name:VELILLA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-400-0555
Mailing Address - Street 1:LOS EUCALIPTOS 17015
Mailing Address - Street 2:PRICE DRIVE
Mailing Address - City:CANOVANAS
Mailing Address - State:PR
Mailing Address - Zip Code:00729
Mailing Address - Country:US
Mailing Address - Phone:787-400-0555
Mailing Address - Fax:
Practice Address - Street 1:1573 AVENIDA JESUS T. PINERO
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00920
Practice Address - Country:US
Practice Address - Phone:787-400-0555
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-12
Last Update Date:2022-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service