Provider Demographics
NPI:1831323815
Name:SOLO OPTICA LLC
Entity Type:Organization
Organization Name:SOLO OPTICA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:
Authorized Official - Last Name:PAGAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-200-4677
Mailing Address - Street 1:RR 8 BOX 1995
Mailing Address - Street 2:
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00956-9825
Mailing Address - Country:US
Mailing Address - Phone:787-200-4677
Mailing Address - Fax:787-200-4677
Practice Address - Street 1:AVE. SANTA JUANITA BB-24 URB. SANTA JUANITA
Practice Address - Street 2:
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00956
Practice Address - Country:US
Practice Address - Phone:787-200-4677
Practice Address - Fax:787-200-4677
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-06
Last Update Date:2021-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR503332H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier