Provider Demographics
NPI:1245003581
Name:WRT OPTICAL SERVICES LLC
Entity type:Organization
Organization Name:WRT OPTICAL SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:WENCESLAO
Authorized Official - Middle Name:
Authorized Official - Last Name:REYES TORO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-605-7317
Mailing Address - Street 1:URB.VENUS GARDENS 1753 CALLE PAFOS
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:URB.VENUS GARDENS 1753 CALLE PAFOS
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00926
Practice Address - Country:US
Practice Address - Phone:787-605-7317
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-30
Last Update Date:2023-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier