Provider Demographics
NPI:1891099107
Name:SCR EMPRESAS VISUALES, PSC
Entity Type:Organization
Organization Name:SCR EMPRESAS VISUALES, PSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SORIVETT
Authorized Official - Middle Name:
Authorized Official - Last Name:COTTO-ROSARIO
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:787-703-0799
Mailing Address - Street 1:N22 CALLE 15
Mailing Address - Street 2:URB SANTA JUANA
Mailing Address - City:CAGUAS
Mailing Address - State:PR
Mailing Address - Zip Code:00725-2042
Mailing Address - Country:US
Mailing Address - Phone:787-703-0799
Mailing Address - Fax:787-905-7335
Practice Address - Street 1:LOS PRADOS MALL
Practice Address - Street 2:BLVD LOS PRADOS SUITE 780
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00727-9507
Practice Address - Country:US
Practice Address - Phone:787-703-0799
Practice Address - Fax:787-905-7335
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-29
Last Update Date:2015-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR405332H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR005-8160AMedicare PIN