Provider Demographics
NPI:1396942686
Name:OPTILOOK
Entity type:Organization
Organization Name:OPTILOOK
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:ANTONIO
Authorized Official - Last Name:RIVERA
Authorized Official - Suffix:
Authorized Official - Credentials:OPTOMETRIS
Authorized Official - Phone:787-278-5932
Mailing Address - Street 1:693 RD # 4211
Mailing Address - Street 2:SUITE 20
Mailing Address - City:DORADO
Mailing Address - State:PR
Mailing Address - Zip Code:00646-4805
Mailing Address - Country:US
Mailing Address - Phone:787-278-5932
Mailing Address - Fax:787-278-5912
Practice Address - Street 1:693 RD # 4211
Practice Address - Street 2:SUITE 20
Practice Address - City:DORADO
Practice Address - State:PR
Practice Address - Zip Code:00646-4805
Practice Address - Country:US
Practice Address - Phone:787-278-5932
Practice Address - Fax:787-278-5912
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier