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General NPI Number Information
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NPI Number | 1053024729
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Entity Type | Organization
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Legal Business Name | OPTICA BUENA LLC
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Dates
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Enumeration Date | 12/27/2022
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Last Update Date | 12/27/2022
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Provider Practice Location Address
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Address Line | 56 CALLE COMERCIO
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City | JUANA DIAZ
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State | PR
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Zip | 00795-1633
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Country | US
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Telephone | 787-837-9608
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Fax |
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Provider Business Mailing Address
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Address Line | 56 CALLE COMERCIO
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City | JUANA DIAZ
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State | PR
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Zip | 00795-1633
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Country | US
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Telephone | 787-837-9608
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | KARLA MALDONADO
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Credential |
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Telephone | 787-412-3220
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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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