Provider Demographics
NPI:1790996585
Name:DR. MARGARET MATOS
Entity Type:Organization
Organization Name:DR. MARGARET MATOS
Other - Org Name:CUPEY VISION- OPTOMETRY WORLD
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MARGARET
Authorized Official - Middle Name:L
Authorized Official - Last Name:MATOS
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:787-760-0950
Mailing Address - Street 1:404 CALLE SAN CLAUDIO
Mailing Address - Street 2:SAGRADO CORAZON
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926-4107
Mailing Address - Country:US
Mailing Address - Phone:787-760-0950
Mailing Address - Fax:787-748-9207
Practice Address - Street 1:404 CALLE SAN CLAUDIO
Practice Address - Street 2:SAGRADO CORAZON
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00926-4107
Practice Address - Country:US
Practice Address - Phone:787-760-0950
Practice Address - Fax:787-748-9207
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR155-080152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR58103Medicare ID - Type Unspecified