Provider Demographics
NPI:1427557768
Name:CENTROVISION OPTICAL GROUP, INC
Entity Type:Organization
Organization Name:CENTROVISION OPTICAL GROUP, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JOACHIM
Authorized Official - Middle Name:
Authorized Official - Last Name:MURATI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-754-5181
Mailing Address - Street 1:652 AVE MUNOZ RIVERA
Mailing Address - Street 2:MONTE MALL SUITE 1015
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00918
Mailing Address - Country:US
Mailing Address - Phone:787-764-4848
Mailing Address - Fax:787-765-0305
Practice Address - Street 1:652 AVE MUNOZ RIVERA
Practice Address - Street 2:MONTE MALL SUITE 1015
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00918
Practice Address - Country:US
Practice Address - Phone:787-764-4848
Practice Address - Fax:787-765-0305
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-02-01
Last Update Date:2018-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty