Healthcare Provider Details

I. General information

NPI: 1265219836
Provider Name (Legal Business Name): PRIMARY EYE CARE OPTOMETRICS PR LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/08/2023
Last Update Date: 09/08/2023
Certification Date: 09/08/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

975 AVE HOSTOS STE 2100
MAYAGUEZ PR
00680-1252
US

IV. Provider business mailing address

PO BOX 1902
SAN GERMAN PR
00683-1902
US

V. Phone/Fax

Practice location:
  • Phone: 787-832-2280
  • Fax:
Mailing address:
  • Phone: 787-955-9144
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number State

VIII. Authorized Official

Name: ZULMARIS TORRES
Title or Position: PRESIDENT
Credential: OD
Phone: 787-955-9144