Healthcare Provider Details

I. General information

NPI: 1205041399
Provider Name (Legal Business Name): EYE CARE AND OPTICAL CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/11/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PLAZA SALINAS SHOPPING CTR LOCAL 1
SALINAS PR
00751
US

IV. Provider business mailing address

PLAZA SALINAS SHOPPING CTR LOCAL 1
SALINAS PR
00751
US

V. Phone/Fax

Practice location:
  • Phone: 787-824-1414
  • Fax: 787-824-1414
Mailing address:
  • Phone: 787-824-1414
  • Fax: 787-824-1414

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number584
License Number StatePR
# 2
Primary TaxonomyN
Taxonomy Code332H00000X
TaxonomyEyewear Supplier
License Number
License Number State

VIII. Authorized Official

Name: DR. MARIA ANCA
Title or Position: PRESIDENT
Credential: O.D.
Phone: 787-824-1414