Healthcare Provider Details

I. General information

NPI: 1174184204
Provider Name (Legal Business Name): VISION ONE CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/28/2019
Last Update Date: 07/05/2022
Certification Date: 07/05/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

88 CALLE CORDOBA
AGUADILLA PR
00603-5845
US

IV. Provider business mailing address

3241 AVE MILITAR
ISABELA PR
00662-4091
US

V. Phone/Fax

Practice location:
  • Phone: 787-882-8367
  • Fax: 787-882-8365
Mailing address:
  • Phone: 787-830-9000
  • Fax: 787-830-9001

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332H00000X
TaxonomyEyewear Supplier
License Number
License Number State

VIII. Authorized Official

Name: MRS. ERIKA SERRANO
Title or Position: PRESIDENT
Credential:
Phone: 787-830-9000