Provider Demographics
NPI:1518258599
Name:LOGUS INC
Entity Type:Organization
Organization Name:LOGUS INC
Other - Org Name:LENS CORNER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:YAIMI
Authorized Official - Middle Name:
Authorized Official - Last Name:ROMERO
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:787-852-2125
Mailing Address - Street 1:EL COMANDANTE AVE.
Mailing Address - Street 2:HN-20 COUNTRY CLUB
Mailing Address - City:CAROLINA
Mailing Address - State:PR
Mailing Address - Zip Code:00982
Mailing Address - Country:US
Mailing Address - Phone:787-852-2125
Mailing Address - Fax:787-852-2125
Practice Address - Street 1:200 BOULEVARD DR. VIDAL ST.
Practice Address - Street 2:SUITE 41
Practice Address - City:HUMACAO
Practice Address - State:PR
Practice Address - Zip Code:00791
Practice Address - Country:US
Practice Address - Phone:787-852-2125
Practice Address - Fax:787-852-2125
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-26
Last Update Date:2011-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR610152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR0056636Medicare PIN
PR98294Medicare UPIN