Provider Demographics
NPI:1518665561
Name:GRUPO OPTOMETRICO ALTAMIRA LLC
Entity Type:Organization
Organization Name:GRUPO OPTOMETRICO ALTAMIRA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRA
Authorized Official - Prefix:
Authorized Official - First Name:FRANSHESKA
Authorized Official - Middle Name:
Authorized Official - Last Name:MARTINEZ MEDINA
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:787-600-2435
Mailing Address - Street 1:PMB 333 P.O.BOX 7891
Mailing Address - Street 2:
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00970
Mailing Address - Country:US
Mailing Address - Phone:787-648-0457
Mailing Address - Fax:
Practice Address - Street 1:130 MARGINAL MTZ NADAL
Practice Address - Street 2:LOS JARDINES SHOPPING CTR
Practice Address - City:GUAYNABO
Practice Address - State:PR
Practice Address - Zip Code:00970-0097
Practice Address - Country:US
Practice Address - Phone:787-625-9144
Practice Address - Fax:787-720-2697
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-20
Last Update Date:2024-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty