Provider Demographics
NPI:1639448111
Name:C.B. OPTICAL SERVICES INC
Entity Type:Organization
Organization Name:C.B. OPTICAL SERVICES INC
Other - Org Name:EYE CONCEPT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OPTOMETRIST / PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROSA
Authorized Official - Middle Name:
Authorized Official - Last Name:CAMACHO MENDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:787-785-3220
Mailing Address - Street 1:1500 AVE COMERIO STE 70
Mailing Address - Street 2:PLAZA DEL PARQUE LOCAL 6
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00961-3977
Mailing Address - Country:US
Mailing Address - Phone:787-785-3220
Mailing Address - Fax:787-785-3705
Practice Address - Street 1:1500 AVE COMERIO STE 70
Practice Address - Street 2:PLAZA DEL PARQUE LOCAL 6
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00961-3977
Practice Address - Country:US
Practice Address - Phone:787-785-3220
Practice Address - Fax:787-785-3705
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-29
Last Update Date:2014-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR264152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty