Provider Demographics
NPI:1245634922
Name:ABBOT OPTICAL LENS INC.
Entity type:Organization
Organization Name:ABBOT OPTICAL LENS INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JULIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:ORTIZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-876-8409
Mailing Address - Street 1:E 206 CALLE VIOLETA
Mailing Address - Street 2:LOIZA VALLEY
Mailing Address - City:CANOVANAS
Mailing Address - State:PR
Mailing Address - Zip Code:00729-3549
Mailing Address - Country:US
Mailing Address - Phone:787-876-8409
Mailing Address - Fax:787-256-3867
Practice Address - Street 1:CARR 188 KM 0.7 EDIF M-1090
Practice Address - Street 2:ZONA INDUSTRIAL SAN ISIDRO
Practice Address - City:CANOVANAS
Practice Address - State:PR
Practice Address - Zip Code:00729
Practice Address - Country:US
Practice Address - Phone:787-876-8409
Practice Address - Fax:787-256-3867
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-09
Last Update Date:2019-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR597156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOpticianGroup - Single Specialty