Provider Demographics
NPI:1780033571
Name:VEOVEO OPTIKA, LLC
Entity Type:Organization
Organization Name:VEOVEO OPTIKA, LLC
Other - Org Name:VEOVEO OPTIKA, LLC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:DRA
Authorized Official - Prefix:DR
Authorized Official - First Name:LIZZETTE
Authorized Official - Middle Name:M
Authorized Official - Last Name:IRIZARRY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-544-8878
Mailing Address - Street 1:138 AVENIDA WINSTON CHURCHUS
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926
Mailing Address - Country:US
Mailing Address - Phone:954-544-8878
Mailing Address - Fax:
Practice Address - Street 1:LOCAL 130 B 18400
Practice Address - Street 2:STATE ROAD NUMERO 3 SUITE 505
Practice Address - City:CANOVANAS
Practice Address - State:PR
Practice Address - Zip Code:00729
Practice Address - Country:US
Practice Address - Phone:954-544-8878
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:VEOVEO OPTIKA,L LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-06-13
Last Update Date:2016-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR00386152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty