Provider Demographics
NPI:1467762153
Name:VISION WORKS OF PUERTO RICO INC
Entity Type:Organization
Organization Name:VISION WORKS OF PUERTO RICO INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTICIAN
Authorized Official - Prefix:
Authorized Official - First Name:MIGUEL
Authorized Official - Middle Name:A
Authorized Official - Last Name:LOPEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-285-6408
Mailing Address - Street 1:69 CALLE ULISES MARTINEZ S
Mailing Address - Street 2:
Mailing Address - City:HUMACAO
Mailing Address - State:PR
Mailing Address - Zip Code:00791-4120
Mailing Address - Country:US
Mailing Address - Phone:787-285-6408
Mailing Address - Fax:787-285-9408
Practice Address - Street 1:69 CALLE ULISES MARTINEZ S
Practice Address - Street 2:
Practice Address - City:HUMACAO
Practice Address - State:PR
Practice Address - Zip Code:00791-4120
Practice Address - Country:US
Practice Address - Phone:787-285-6408
Practice Address - Fax:787-285-9408
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-14
Last Update Date:2010-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier