Healthcare Provider Details

I. General information

NPI: 1679452056
Provider Name (Legal Business Name): MEL OPTICAL INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/29/2025
Last Update Date: 08/29/2025
Certification Date: 08/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

KM 8.3 CALLE 3 AVE 65 INF HOSPITAL UPR DR FEDERICO TRILLA
CAROLINA PR
00984
US

IV. Provider business mailing address

402 CALLE AZALEA
CAROLINA PR
00987-8728
US

V. Phone/Fax

Practice location:
  • Phone: 787-757-1800
  • Fax:
Mailing address:
  • Phone: 787-243-3187
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code156FX1202X
TaxonomyOptometric Technician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332H00000X
TaxonomyEyewear Supplier
License Number
License Number State

VIII. Authorized Official

Name: MS. MYRNA GARCIA DIAZ
Title or Position: PRESIDENT
Credential:
Phone: 787-512-0253