Provider Demographics
NPI:1891133849
Name:DRA CARLA I CABALLERO & ASOCIADOS PSC
Entity Type:Organization
Organization Name:DRA CARLA I CABALLERO & ASOCIADOS PSC
Other - Org Name:CYBER OPTICAL EYEWEAR BOUTIQUE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OPTICAL MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:EUGENIO
Authorized Official - Middle Name:LUIS
Authorized Official - Last Name:TORRES AYALA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-918-8820
Mailing Address - Street 1:LA GALERIA DE SUCHVILLE
Mailing Address - Street 2:97 CARR PR2 STE 216
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00966-2039
Mailing Address - Country:US
Mailing Address - Phone:787-918-8820
Mailing Address - Fax:787-200-5514
Practice Address - Street 1:LA GALERIA DE SUCHVILLE
Practice Address - Street 2:97 CARR PR2 STE 216
Practice Address - City:GUAYNABO
Practice Address - State:PR
Practice Address - Zip Code:00966-2039
Practice Address - Country:US
Practice Address - Phone:787-918-8820
Practice Address - Fax:787-200-5514
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-12
Last Update Date:2014-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR675152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty