Provider Demographics
NPI:1508916560
Name:SANGIOVANNI-ALMONTE, WANDA (OD)
Entity Type:Individual
Prefix:
First Name:WANDA
Middle Name:
Last Name:SANGIOVANNI-ALMONTE
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:ILORI OPTICAL PLAZA LAS AMERICAS MALL
Mailing Address - Street 2:525 AVE FD ROOSEVELT
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00918
Mailing Address - Country:US
Mailing Address - Phone:787-766-1872
Mailing Address - Fax:
Practice Address - Street 1:ILORI OPTICAL
Practice Address - Street 2:525 AVE FD ROOSEVELT
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00918
Practice Address - Country:US
Practice Address - Phone:787-766-1872
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-11
Last Update Date:2016-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR570152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist