Provider Demographics
NPI:1710560735
Name:LENS FACTORY FOR YOU
Entity Type:Organization
Organization Name:LENS FACTORY FOR YOU
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:L
Authorized Official - Last Name:BURGOS
Authorized Official - Suffix:
Authorized Official - Credentials:OP
Authorized Official - Phone:787-299-5828
Mailing Address - Street 1:PO BOX 4195
Mailing Address - Street 2:
Mailing Address - City:CAROLINA
Mailing Address - State:PR
Mailing Address - Zip Code:00984-4195
Mailing Address - Country:US
Mailing Address - Phone:939-255-3812
Mailing Address - Fax:877-408-9167
Practice Address - Street 1:AVENDIA PONCE DE LEON 1116
Practice Address - Street 2:
Practice Address - City:SAN JAUN
Practice Address - State:PR
Practice Address - Zip Code:00907
Practice Address - Country:US
Practice Address - Phone:939-255-3812
Practice Address - Fax:877-408-9167
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-29
Last Update Date:2021-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier