Provider Demographics
NPI:1801544788
Name:PLERION OPTICAL OUTLET LLC
Entity type:Organization
Organization Name:PLERION OPTICAL OUTLET LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTICIAN
Authorized Official - Prefix:MR
Authorized Official - First Name:OSCAR
Authorized Official - Middle Name:MANUEL
Authorized Official - Last Name:BARRETO REYES
Authorized Official - Suffix:
Authorized Official - Credentials:LIC: 1203
Authorized Official - Phone:787-310-3645
Mailing Address - Street 1:PO BOX 1026
Mailing Address - Street 2:
Mailing Address - City:CANOVANAS
Mailing Address - State:PR
Mailing Address - Zip Code:00729
Mailing Address - Country:US
Mailing Address - Phone:787-326-8094
Mailing Address - Fax:
Practice Address - Street 1:PLAZA ITURREGUI SHOPPING CENTER 1135 AVE 65 INFANTERIA
Practice Address - Street 2:SUITE 222-A
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00924
Practice Address - Country:US
Practice Address - Phone:787-310-3645
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-10
Last Update Date:2024-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier