Provider Demographics
NPI:1659917540
Name:CIALES CENTRO VISUAL CORP.
Entity Type:Organization
Organization Name:CIALES CENTRO VISUAL CORP.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENTE
Authorized Official - Prefix:MRS
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:E
Authorized Official - Last Name:WHATTS
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:787-925-6808
Mailing Address - Street 1:51 CALLE JOSE DE DIEGO
Mailing Address - Street 2:
Mailing Address - City:CIALES
Mailing Address - State:PR
Mailing Address - Zip Code:00638-3228
Mailing Address - Country:US
Mailing Address - Phone:787-925-6808
Mailing Address - Fax:
Practice Address - Street 1:51 CALLE JOSE DE DIEGO
Practice Address - Street 2:
Practice Address - City:CIALES
Practice Address - State:PR
Practice Address - Zip Code:00638-3228
Practice Address - Country:US
Practice Address - Phone:787-925-6808
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-26
Last Update Date:2019-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty
No156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOpticianGroup - Multi-Specialty