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General NPI Number Information
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NPI Number | 1063557999
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Entity Type | Organization
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Legal Business Name | OPTOMETRY MASTER C.S.P.
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Dates
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Enumeration Date | 02/20/2007
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Last Update Date | 02/21/2017
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Provider Practice Location Address
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Address Line | PLAZA CUPEY GARDENS 200 AVENUE CUPEY GARDENS, SUITE 2W
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City | SAN JUAN
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State | PR
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Zip | 00926
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Country | US
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Telephone | 787-283-7080
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Fax | 787-283-7080
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Provider Business Mailing Address
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Address Line | PLAZA CUPEY GARDENS 200 AVE. CUPEY GARDENS, SUITE 2W
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City | SAN JUAN
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State | PR
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Zip | 00926
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Country | US
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Telephone | 787-283-7080
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Fax | 787-283-7080
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. KELVIN TORRES
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Credential | O.D.
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Telephone | 787-283-7080
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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 | 438
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License Number State | PR
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