Healthcare Provider Details

I. General information

NPI: 1265978852
Provider Name (Legal Business Name): J&F OPTICAL SERVICE INCORPORATED
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/06/2017
Last Update Date: 02/19/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

B275 CARR 693 DORAMAR PLAZA
DORADO PR
00646
US

IV. Provider business mailing address

PO BOX 7891 PMB 333
GUAYNABO PR
00970
US

V. Phone/Fax

Practice location:
  • Phone: 787-980-8008
  • Fax:
Mailing address:
  • Phone: 787-637-8688
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code156F00000X
TaxonomyTechnician/Technologist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code156FX1800X
TaxonomyOptician
License Number1211
License Number StatePR

VIII. Authorized Official

Name: FRANCIS D MEDINA
Title or Position: OWNER/VICEPRESIDENT
Credential:
Phone: 787-782-2175