Healthcare Provider Details

I. General information

NPI: 1881231546
Provider Name (Legal Business Name): LE PETIT VISION CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/02/2019
Last Update Date: 08/18/2026
Certification Date: 08/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CONSOLIDATED MALL C-22, AVE GAUTIER BENITEZ 202
CAGUAS PR
00725-9998
US

IV. Provider business mailing address

PO BOX 9192
CAGUAS PR
00726-9192
US

V. Phone/Fax

Practice location:
  • Phone: 787-744-2821
  • Fax: 787-957-8680
Mailing address:
  • Phone: 787-744-2821
  • Fax: 787-957-8680

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332H00000X
TaxonomyEyewear Supplier
License Number
License Number State

VIII. Authorized Official

Name: DR. JUAN M. VAZQUEZ
Title or Position: PRESIDENT
Credential: OD
Phone: 787-504-1302