Provider Demographics
NPI:1629230321
Name:PROFESSIONAL EYE CARE INC
Entity Type:Organization
Organization Name:PROFESSIONAL EYE CARE INC
Other - Org Name:COHENS FASHION OPTICAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:VELAZQUEZ RIVERA
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:787-657-4948
Mailing Address - Street 1:PARQUE ESCORIAL
Mailing Address - Street 2:APT 1433 THE RESIDENCES
Mailing Address - City:CAROLINA
Mailing Address - State:PR
Mailing Address - Zip Code:00987
Mailing Address - Country:US
Mailing Address - Phone:787-657-4947
Mailing Address - Fax:
Practice Address - Street 1:CAROLINA SHOPP CTR # 245
Practice Address - Street 2:FRAGOSO AVENUE
Practice Address - City:CAROLINA
Practice Address - State:PR
Practice Address - Zip Code:00985-5672
Practice Address - Country:US
Practice Address - Phone:787-657-4948
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-25
Last Update Date:2008-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR332H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier