Provider Demographics
NPI:1770282980
Name:WD VISION LLC
Entity type:Organization
Organization Name:WD VISION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:WILFREDO
Authorized Official - Middle Name:
Authorized Official - Last Name:CRUZ
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:787-513-4187
Mailing Address - Street 1:10 AVE LAS CUMBRES
Mailing Address - Street 2:SUITE 104
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00969-4836
Mailing Address - Country:US
Mailing Address - Phone:787-513-4187
Mailing Address - Fax:787-258-8225
Practice Address - Street 1:10 AVE LAS CUMBRES
Practice Address - Street 2:SUITE 104
Practice Address - City:GUAYNABO
Practice Address - State:PR
Practice Address - Zip Code:00969-4836
Practice Address - Country:US
Practice Address - Phone:787-513-4187
Practice Address - Fax:787-258-8225
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-27
Last Update Date:2023-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes332H00000XSuppliersEyewear Supplier
No156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOpticianGroup - Multi-Specialty
No152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty