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General NPI Number Information
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NPI Number | 1023779618
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Entity Type | Organization
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Legal Business Name | C-EYE OPTICAL
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Dates
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Enumeration Date | 01/05/2022
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Last Update Date | 01/11/2022
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Provider Practice Location Address
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Address Line | 450 CALLE FERROCARRIL STE 102 SANTA MARIA MEDICAL BUILDING
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City | PONCE
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State | PR
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Zip | 00717-0071
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Country | US
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Telephone | 787-651-6001
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Fax | 787-651-6002
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Provider Business Mailing Address
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Address Line | 450 CALLE FERROCARRIL STE 102 SANTA MARIA MEDICAL BUILDING
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City | PONCE
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State | PR
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Zip | 00717-4105
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Country | US
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Telephone | 787-651-6001
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | CHAIMARIE DIAZ
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Credential |
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Telephone | 787-651-6001
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332H00000X
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Taxonomy Name | Eyewear Supplier
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License Number |
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License Number State |
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