MEDICARE: VANESSA ALBO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	156FX1800X	Optician
2	332H00000X	Eyewear Supplier		PR

General Provider Information

NPI Number	:	1083472146
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VANESSA ALBO

Provider Business Mailing Address
First Line	:	HC 70 BOX 30461
Second Line	:
City	:	SAN LORENZO
State	:	PR
Zip	:	00754-9705
Country	:	US
Telephone Number	:	787-639-6599
Fax Number	:

Provider Business Practice Location Address
First Line	:	AVENIDA PRINCIPAL MUNOZ RIVERA
Second Line	:	LOCAL # 150
City	:	SAN LORENZO
State	:	PR
Zip	:	00754-0000
Country	:	US
Telephone Number	:	787-639-6599
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/12/2024
Last Update Date	:	05/30/2024

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Directions to “ VANESSA ALBO ” Practice Location

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