Provider Demographics
NPI:1649958448
Name:VISTA FAMILY EYE CARE, LLC
Entity type:Organization
Organization Name:VISTA FAMILY EYE CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:NOELIS
Authorized Official - Middle Name:
Authorized Official - Last Name:CINTRON
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:787-854-1551
Mailing Address - Street 1:1769 CALLE BUDAPEST
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00921-4331
Mailing Address - Country:US
Mailing Address - Phone:787-854-1551
Mailing Address - Fax:
Practice Address - Street 1:EDIFICIO SAN JOSE OFIC 202
Practice Address - Street 2:CARR #5 KM 21.8 BO GUADIANA
Practice Address - City:NARANJTO
Practice Address - State:PR
Practice Address - Zip Code:00719
Practice Address - Country:US
Practice Address - Phone:787-854-1551
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-11
Last Update Date:2023-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty