Healthcare Provider Details

I. General information

NPI: 1437066743
Provider Name (Legal Business Name): CALOVARE OPTICAL LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/25/2026
Last Update Date: 08/25/2026
Certification Date: 08/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

852 CALLE CAMPECHE ESQ. BUENOS AIRES SUITE #02
PONCE PR
00717-1672
US

IV. Provider business mailing address

852 CALLE CAMPECHE ESQ. BUENOS AIRES SUITE #02
PONCE PR
00717-1672
US

V. Phone/Fax

Practice location:
  • Phone: 787-590-6958
  • Fax:
Mailing address:
  • Phone: 787-590-6958
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code156FX1800X
TaxonomyOptician
License Number
License Number State

VIII. Authorized Official

Name: MS. BELEN M RULLAN SIERRA
Title or Position: LIC OPTICIAN
Credential: OPTICIAN
Phone: 787-590-6958