Provider Demographics
NPI:1912505850
Name:OPTICAL DESIGNERS
Entity Type:Organization
Organization Name:OPTICAL DESIGNERS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTICIAN
Authorized Official - Prefix:
Authorized Official - First Name:MANUEL
Authorized Official - Middle Name:G
Authorized Official - Last Name:SANCHEZ LATONI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-378-2520
Mailing Address - Street 1:27 CALLE CAOBA
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00913-4720
Mailing Address - Country:US
Mailing Address - Phone:787-378-2520
Mailing Address - Fax:
Practice Address - Street 1:1357 AVE LUIS VIGOREAUX
Practice Address - Street 2:
Practice Address - City:GUAYNABO
Practice Address - State:PR
Practice Address - Zip Code:00966-2700
Practice Address - Country:US
Practice Address - Phone:787-783-8030
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-13
Last Update Date:2023-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOpticianGroup - Single Specialty