Provider Demographics
NPI:1851485676
Name:OPTICAL ENTERPRISES OF PR INC
Entity Type:Organization
Organization Name:OPTICAL ENTERPRISES OF PR INC
Other - Org Name:VISION WORLD
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ABERLYN
Authorized Official - Middle Name:
Authorized Official - Last Name:GARCIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-261-4886
Mailing Address - Street 1:PMB 327
Mailing Address - Street 2:RIO HONDO AVE. #90
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00962-3105
Mailing Address - Country:US
Mailing Address - Phone:787-261-4886
Mailing Address - Fax:787-261-4896
Practice Address - Street 1:PMB 327
Practice Address - Street 2:RIO HONDO AVE #90
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00962-3105
Practice Address - Country:US
Practice Address - Phone:787-261-4886
Practice Address - Fax:787-261-4896
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-03
Last Update Date:2009-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR379152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR100228OtherCRUZ AZUL
PR68030OtherTRIPLE S
PRVW 001OtherVISION HEMISFERICA
PRVW 001OtherVISION HEMISFERICA