Provider Demographics
NPI:1609489905
Name:EYE OPTICAL SERVICE & MANAGEMENT GROUP
Entity Type:Organization
Organization Name:EYE OPTICAL SERVICE & MANAGEMENT GROUP
Other - Org Name:INNOVA OPTICA UNO
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LORNA
Authorized Official - Middle Name:
Authorized Official - Last Name:TORRES HERNANDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-535-1001
Mailing Address - Street 1:PO BOX 2058
Mailing Address - Street 2:
Mailing Address - City:AIBONITO
Mailing Address - State:PR
Mailing Address - Zip Code:00705-2058
Mailing Address - Country:US
Mailing Address - Phone:787-535-1001
Mailing Address - Fax:
Practice Address - Street 1:PR-14 SECTOR LOMAS BO. RINCON
Practice Address - Street 2:TORRE MEDICA CENTRO MEDICO HOSPITAL MENONITA PRIMER PIS
Practice Address - City:CAYEY
Practice Address - State:PR
Practice Address - Zip Code:00736
Practice Address - Country:US
Practice Address - Phone:787-535-1001
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:EYE OPTICAL SERVICES & MANAGEMENT GROUP INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-08-26
Last Update Date:2021-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes332H00000XSuppliersEyewear Supplier
No156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOpticianGroup - Single Specialty