Healthcare Provider Details

I. General information

NPI: 1639003874
Provider Name (Legal Business Name): EYE DR CARE CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/11/2026
Last Update Date: 06/11/2026
Certification Date: 05/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

TORRE DEL METROPOLITANO SUITE 20 1789 STATE ROAD PR 21
SAN JUAN PR
00922-4809
US

IV. Provider business mailing address

TORRE DEL METROPOLITANO SUITE 20 1789 STATE ROAD PR 21
SAN JUAN PR
00922-4809
US

V. Phone/Fax

Practice location:
  • Phone: 787-671-0546
  • Fax:
Mailing address:
  • Phone: 787-671-0546
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number State

VIII. Authorized Official

Name: HECTOR MORENO
Title or Position: OPTOMETRIST
Credential: OD
Phone: 787-671-0546