Provider Demographics
NPI:1982995783
Name:SANTA LUCIA OPTICA INC
Entity Type:Organization
Organization Name:SANTA LUCIA OPTICA INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SERVICIO AL CLIENTE
Authorized Official - Prefix:
Authorized Official - First Name:CARLA
Authorized Official - Middle Name:ALEJANDRA
Authorized Official - Last Name:HERNANDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-210-2201
Mailing Address - Street 1:PO BOX 51688
Mailing Address - Street 2:
Mailing Address - City:TOA BAJA
Mailing Address - State:PR
Mailing Address - Zip Code:00950-1688
Mailing Address - Country:US
Mailing Address - Phone:787-210-2201
Mailing Address - Fax:
Practice Address - Street 1:AV CAMPO RIVO URB COUNTRY CLUB
Practice Address - Street 2:GP13
Practice Address - City:CAROLINA
Practice Address - State:PR
Practice Address - Zip Code:00985
Practice Address - Country:US
Practice Address - Phone:787-210-2201
Practice Address - Fax:787-294-9559
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-27
Last Update Date:2011-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty