Healthcare Provider Details

I. General information

NPI: 1801351796
Provider Name (Legal Business Name): QUALITY VISION CENTER INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/05/2019
Last Update Date: 02/05/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

511 AVE JOSE A CEDENO
ARECIBO PR
00612-4695
US

IV. Provider business mailing address

PO BOX 141176
ARECIBO PR
00614-1176
US

V. Phone/Fax

Practice location:
  • Phone: 787-880-3362
  • Fax:
Mailing address:
  • Phone: 787-880-3362
  • Fax:

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: JOEL CASTRO
Title or Position: PRESIDENT
Credential:
Phone: 787-510-8184