Healthcare Provider Details

I. General information

NPI: 1992153944
Provider Name (Legal Business Name): UNIQUE OPTICAL INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/01/2016
Last Update Date: 01/16/2024
Certification Date: 01/15/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CALLE 18 N34 TOA ALTA HEIGHTS
TOA ALTA PR
00953
US

IV. Provider business mailing address

TOA ALTA HEIGHTS CALLE 18 N-34
TOA ALTA PR
00953
US

V. Phone/Fax

Practice location:
  • Phone: 787-462-5062
  • Fax:
Mailing address:
  • Phone: 787-231-4433
  • Fax: 787-925-1171

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: PABLO MORALES
Title or Position: OWNER
Credential:
Phone: 787-462-5062