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General NPI Number Information
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NPI Number | 1013213446
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Entity Type | Organization
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Legal Business Name | CENTRO OPTOMETRICO DRA MONTESINOS INC
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Dates
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Enumeration Date | 02/02/2011
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Last Update Date | 09/16/2022
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Provider Practice Location Address
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Address Line | CALLE DE DIEGO E 53
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City | MAYAGUEZ
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State | PR
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Zip | 00680-4866
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Country | US
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Telephone | 787-805-4444
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Fax |
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Provider Business Mailing Address
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Address Line | CALLE DE DIEGO 53 E
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City | MAYAGUEZ
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State | PR
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Zip | 00680-9998
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Country | US
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Telephone | 787-805-4444
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. MELINDA MONTESINOS HUERFANOS
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Credential | OD
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Telephone | 787-805-4444
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 548
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License Number State | PR
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