Healthcare Provider Details

I. General information

NPI: 1851163463
Provider Name (Legal Business Name): MARCOS ARMANDO PINET OPTICIAN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/26/2023
Last Update Date: 10/26/2023
Certification Date: 10/25/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CARRETERA #3 KM 22.5 URB, RIO GRANDE HILLS
RIO GRANDE PR
00745
US

IV. Provider business mailing address

HC 1 BOX 3801
LOIZA PR
00772
US

V. Phone/Fax

Practice location:
  • Phone: 787-450-0447
  • Fax:
Mailing address:
  • Phone: 787-450-0447
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code156FX1800X
TaxonomyOptician
License Number746
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: