Healthcare Provider Details

I. General information

NPI: 1679186340
Provider Name (Legal Business Name): VISION VEINTE-VEINTE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/24/2020
Last Update Date: 06/10/2022
Certification Date: 06/10/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17 CALLE PERAL N
MAYAGUEZ PR
00680-4822
US

IV. Provider business mailing address

17 CALLE PERAL N
MAYAGUEZ PR
00680-4822
US

V. Phone/Fax

Practice location:
  • Phone: 787-361-5599
  • Fax:
Mailing address:
  • Phone: 787-361-5599
  • 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: DR. MELISSA SUE NATALI
Title or Position: PRESIDENT
Credential: OD
Phone: 787-361-5599