Provider Demographics
NPI:1679706519
Name:20/20 VISION
Entity Type:Organization
Organization Name:20/20 VISION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JANET
Authorized Official - Middle Name:M
Authorized Official - Last Name:LEON
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:787-851-7165
Mailing Address - Street 1:PO BOX 1155
Mailing Address - Street 2:
Mailing Address - City:BOQUERON
Mailing Address - State:PR
Mailing Address - Zip Code:00622-1155
Mailing Address - Country:US
Mailing Address - Phone:787-851-7165
Mailing Address - Fax:
Practice Address - Street 1:31 CALLE BETANCES
Practice Address - Street 2:
Practice Address - City:CABO ROJO
Practice Address - State:PR
Practice Address - Zip Code:00623-4054
Practice Address - Country:US
Practice Address - Phone:787-851-7165
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-26
Last Update Date:2009-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR377332H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier