Provider Demographics
NPI:1891918645
Name:LT OPTICAL INC.
Entity Type:Organization
Organization Name:LT OPTICAL INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LUIS
Authorized Official - Middle Name:JOSE
Authorized Official - Last Name:TOTTI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-852-1155
Mailing Address - Street 1:PO BOX 192971
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00919-2971
Mailing Address - Country:US
Mailing Address - Phone:787-852-1155
Mailing Address - Fax:787-852-1155
Practice Address - Street 1:353 CALLE FONT MARTELO STE 2
Practice Address - Street 2:
Practice Address - City:HUMACAO
Practice Address - State:PR
Practice Address - Zip Code:00791-3225
Practice Address - Country:US
Practice Address - Phone:787-852-1155
Practice Address - Fax:787-852-1155
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-10
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR253152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR077126OtherCRUZ AZUL
PR4201OtherAMERICAN HEALTH MEDICARE
PR50590OtherPMC
PR58098TOOtherSSS
PR5-8098TOOtherMEDICARE OPTIMO
PR00080OtherVISION HEMISFERICA