Provider Demographics
NPI:1851510838
Name:OPTOMETRY WORLD-YAUCO
Entity Type:Organization
Organization Name:OPTOMETRY WORLD-YAUCO
Other - Org Name:CONSULTORIO OPTOMETRICO
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MAGALY
Authorized Official - Middle Name:
Authorized Official - Last Name:FIGUEROA
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:787-856-1452
Mailing Address - Street 1:PO BOX 628
Mailing Address - Street 2:
Mailing Address - City:MAYAGUEZ
Mailing Address - State:PR
Mailing Address - Zip Code:00681-0628
Mailing Address - Country:US
Mailing Address - Phone:787-856-1452
Mailing Address - Fax:787-856-6872
Practice Address - Street 1:30 CALLE MATTEI LLUBERAS
Practice Address - Street 2:
Practice Address - City:YAUCO
Practice Address - State:PR
Practice Address - Zip Code:00698-3635
Practice Address - Country:US
Practice Address - Phone:787-856-1452
Practice Address - Fax:787-856-6872
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-25
Last Update Date:2008-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR180-107152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRT26867Medicare UPIN
PR58025Medicare PIN