Healthcare Provider Details

I. General information

NPI: 1013775691
Provider Name (Legal Business Name): MVP OPTICALS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/08/2024
Last Update Date: 03/08/2024
Certification Date: 03/06/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CARR 3 KM 22.5 URB. RIO GRANDE HILLS
RIO GRANDE PR
00745
US

IV. Provider business mailing address

HC 1 BOX 3801
LOIZA PR
00772-9621
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 Number
License Number State

VIII. Authorized Official

Name: MARCOS PINET
Title or Position: OWNER
Credential: OP
Phone: 787-450-0447