Provider Demographics
NPI:1649761867
Name:OJOS CENTRO OPTICO LLC
Entity Type:Organization
Organization Name:OJOS CENTRO OPTICO LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:YOLANDA
Authorized Official - Middle Name:
Authorized Official - Last Name:RODRIGUEZ MORALES
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:407-922-1488
Mailing Address - Street 1:281 CALLE RUIZ BELVIS
Mailing Address - Street 2:
Mailing Address - City:SAN SEBASTIAN
Mailing Address - State:PR
Mailing Address - Zip Code:00685-2335
Mailing Address - Country:US
Mailing Address - Phone:787-896-7040
Mailing Address - Fax:787-896-7050
Practice Address - Street 1:281 CALLE RUIZ BELVIS
Practice Address - Street 2:
Practice Address - City:SAN SEBASTIAN
Practice Address - State:PR
Practice Address - Zip Code:00685
Practice Address - Country:US
Practice Address - Phone:787-896-7040
Practice Address - Fax:787-896-7050
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-23
Last Update Date:2018-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty