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General NPI Number Information
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NPI Number | 1043855919
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Entity Type | Organization
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Legal Business Name | GLASSES OPTICAL INCORPORADO
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Dates
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Enumeration Date | 11/14/2019
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Last Update Date | 08/25/2025
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Provider Practice Location Address
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Address Line | 2939 AVE EMILIO FAGOT STE 2
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City | PONCE
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State | PR
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Zip | 00716-3613
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Country | US
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Telephone | 787-842-7033
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Fax |
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Provider Business Mailing Address
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Address Line | 2939 AVE EMILIO FAGOT STE 2
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City | PONCE
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State | PR
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Zip | 00716-3613
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Country | US
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Telephone | 787-842-7033
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | WILFREDO GAUDINO
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Credential | LICENSED OPTICIAN
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Telephone | 787-420-0783
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 156FX1800X
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Taxonomy Name | Optician
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License Number |
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License Number State |
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