Provider Demographics
NPI:1497729149
Name:VARGAS, OLIMPIA (OD)
Entity Type:Individual
Prefix:
First Name:OLIMPIA
Middle Name:
Last Name:VARGAS
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:H48 MARGINAL SANTA RITA
Mailing Address - Street 2:CARR. #2
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00692
Mailing Address - Country:US
Mailing Address - Phone:787-883-1859
Mailing Address - Fax:787-883-7692
Practice Address - Street 1:CARR. #2 H48 MARGINAL SANTA RITA
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00692
Practice Address - Country:US
Practice Address - Phone:787-883-1859
Practice Address - Fax:787-883-7692
Is Sole Proprietor?:No
Enumeration Date:2006-02-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR145152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist