Provider Demographics
NPI:1659715720
Name:OPTICA L.M. , INC.
Entity Type:Organization
Organization Name:OPTICA L.M. , INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CAROL
Authorized Official - Middle Name:
Authorized Official - Last Name:MALDONADO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-798-0575
Mailing Address - Street 1:PO BOX 703
Mailing Address - Street 2:
Mailing Address - City:TOA BAJA
Mailing Address - State:PR
Mailing Address - Zip Code:00951-0703
Mailing Address - Country:US
Mailing Address - Phone:787-798-0575
Mailing Address - Fax:787-798-0575
Practice Address - Street 1:CARR 863 KM 1.2
Practice Address - Street 2:BO PAJAROS
Practice Address - City:TOA BAJA
Practice Address - State:PR
Practice Address - Zip Code:00949
Practice Address - Country:US
Practice Address - Phone:787-798-0575
Practice Address - Fax:787-798-0575
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-19
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR332B00000X
PR609332H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332H00000XSuppliersEyewear Supplier