Provider Demographics
NPI:1841916178
Name:FAMILY VISION CENTER JUANA DIAZ
Entity type:Organization
Organization Name:FAMILY VISION CENTER JUANA DIAZ
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:HEILEN
Authorized Official - Middle Name:M
Authorized Official - Last Name:DE LA HOZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-643-9250
Mailing Address - Street 1:GALERIAS PONCENAS MALL
Mailing Address - Street 2:CALLE UNION 83 SUITE 129
Mailing Address - City:PONCE
Mailing Address - State:PR
Mailing Address - Zip Code:00730
Mailing Address - Country:US
Mailing Address - Phone:787-844-6000
Mailing Address - Fax:787-813-0843
Practice Address - Street 1:PLAZA JUANA DIAZ
Practice Address - Street 2:CARR 149 LOCAL 6
Practice Address - City:JUANA DIAZ
Practice Address - State:PR
Practice Address - Zip Code:00795
Practice Address - Country:US
Practice Address - Phone:787-260-2588
Practice Address - Fax:787-813-0843
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-18
Last Update Date:2022-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes332H00000XSuppliersEyewear Supplier
No207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
No152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty